The Kid Doctor Pc

NPI 1235388786 - Pediatrics - 208000000X

NPI Details
NPI 1235388786
Enumeration Date 09/09/2008
Last Updated 09/09/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name SHELLIE SHELLIE
Position MANAGER
Phone (912) 383-4352
Fax (912) 384-1192
Practice Location
100 DOCTORS DR
SUITE 104
DOUGLAS GA, 31533-2210, US
Phone (912) 383-4352
Fax (912) 384-1192
Business Location
100 DOCTORS DR
SUITE 104
DOUGLAS GA, 31533-2210, US
Phone (912) 383-4352
Fax (912) 384-1192
Toxanomy
Taxonomy Code 208000000X
License State Georgia
License Number 042212
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According to our database, The Kid Doctor Pc NPI is 1235388786, taxonomy code is 208000000X and license number is 042212, license state is located at Georgia. The Kid Doctor Pc physically located at 100 Doctors Dr, Douglas GA, 31533-2210. NPI Number 1033115704 has the healthcare provider type.

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1235388786 NPI number is provided on an as is basis without warranty of any kind. 1235388786 is maintained by the National Plan & Provider Enumeration System. The contents of The Kid Doctor Pc are for informational purposes only.