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PEDIATRIC ASSOCIATES PC NPI 1790994317


NPI Information

NPI: 1790994317
Provider Name: PEDIATRIC ASSOCIATES, PC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 11D2028521

Address:
3000 JOHNSON FERRY RD
SUITE 204
MARIETTA, GA
ZIP 30062
Phone: (770) 993-2922
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PEDIATRIC ASSOCIATES, PC is a pediatrics in Marietta, GA. 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. PEDIATRIC ASSOCIATES, PC NPI is 1790994317. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3000 JOHNSON FERRY RD
SUITE 204
MARIETTA, GA
ZIP 30062-683
Phone: (770) 993-2922
Fax: (770) 993-7325

The provider's authorized official is Robert M. Licata .
The authorized official title is President and has the following contact phone number (770) 993-2922.

The CLIA number assigned to this NPI record is 11D2028521 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/21/2007 and was last updated on 8/22/2020.


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
1208000000XPediatrics025457GEORGIAYes

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: 11/14/2023

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