Northlake Pediatric Associates,Pc

LBN: Northlake Pediatric Associates,Pc
Northlake Pediatric Associates,Pc is an health care organization with primary practice located at 1805 Parke Plaza Cir Suite 103, Stone Mountain GA 30087-3498. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Northlake Pediatric Associates,Pc can be contacted via phone (770) 498-9355, or through Taliaferro, Delores via phone (770) 498-9355.

Contact Information

Primary practice address
1805 Parke Plaza Cir Suite 103 Stone Mountain GA 30087-3498
Phone: (770) 498-9355
Fax: (770) 498-6294
Website:
Map and Directions
Authorized official contact:
Name: Taliaferro, Delores
Phone: (770) 498-9355

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X

Profile Details

NPI number 1518174036
LBN Legal business name Northlake Pediatric Associates,Pc
DBA Doing business as
Authorized official Taliaferro, Delores
Entity Organization
Organization subpart 1 No
Enumeration date May 16th, 2007
Last updated Jan 8th, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518174036 NPPES
Georgia MEDICAID 85000926G

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