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LEGACY PEDIATRICS NPI 1699903542


NPI Information

NPI: 1699903542
Provider Name: LEGACY PEDIATRICS
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 34D1101942

Address:
556 SANDHURST DR
FAYETTEVILLE, NC
ZIP 28304
Phone: (910) 483-2646
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LEGACY PEDIATRICS is a pediatrics in Fayetteville, NC. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. LEGACY PEDIATRICS NPI is 1699903542. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

556 SANDHURST DR
FAYETTEVILLE, NC
ZIP 28304-426
Phone: (910) 483-2646
Fax: (910) 483-9470

The provider's authorized official is Ana Ceide Hodges .
The authorized official title is Owner/practitioner and has the following contact phone number (910) 483-2646.

The CLIA number assigned to this NPI record is 34D1101942 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/30/2009 and was last updated on 7/12/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics200000824NORTH CAROLINAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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