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EGLESTON PEDIATRIC GROUP NPI 1811041452


NPI Information

NPI: 1811041452
Provider Name: EGLESTON PEDIATRIC GROUP
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
1405 CLIFTON RD NE
ATLANTA, GA
ZIP 30322
Phone: (404) 785-6000
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EGLESTON PEDIATRIC GROUP is a pediatrics in Atlanta, 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. EGLESTON PEDIATRIC GROUP NPI is 1811041452. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1405 CLIFTON RD NE
ATLANTA, GA
ZIP 30322-060
Phone: (404) 785-6000

The provider's authorized official is Louetta Cody .
The authorized official title is Manager, Provider Enrollment and has the following contact phone number (404) 785-7876.

The enumeration date for this NPI number is 1/22/2007 and was last updated on 3/28/2023.


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
12080P0203XPediatricsPediatric Critical Care MedicineNo
22080P0204XPediatricsPediatric Emergency MedicineNo
32080P0205XPediatricsPediatric EndocrinologyNo
4363AM0700XPhysician AssistantMedicalNo
5363LP0200XNurse PractitionerPediatricsNo
6363LP0222XNurse PractitionerPediatrics, Critical CareNo
7363LP2300XNurse PractitionerPrimary CareNo
8208000000XPediatricsYes

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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