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NPI Code Detail

MEDICARE: PEDIATRIC ACQUISITION, INC

MEDICARE: PEDIATRIC ACQUISITION, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician

General Provider Information

NPI Number : 1750390738
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEDIATRIC ACQUISITION, INC
Provider Business Mailing Address
First Line : 1522 CLAREMONT AVE
Second Line :
City : ASHLAND
State : OH
Zip : 44805-3533
Country : US
Telephone Number : 419-207-1085
Fax Number : 419-207-0607
Provider Business Practice Location Address
First Line : 1522 CLAREMONT AVE
Second Line :
City : ASHLAND
State : OH
Zip : 44805-3533
Country : US
Telephone Number : 419-207-1085
Fax Number : 419-207-0607
Authorized Official
Title or Position : OFFICE MANAGER
Name : JANEANE SHEPPARD
Credential :
Telephone Number : 419-207-1085
Provider Enumeration Date : 08/07/2006
Last Update Date : 07/15/2011

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Directions to “PEDIATRIC ACQUISITION, INC ” Practice Location

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