ZOE CENTER FOR PEDIATRIC & ADOLESCENT HEALTH LLC NPI 1053684936

NPI Information

NPI: 1053684936
Provider Name: ZOE CENTER FOR PEDIATRIC & ADOLESCENT HEALTH, LLC
Classification: Pediatrics - 2080A0000X
Entity Type: Organization

Specialization: Adolescent Medicine

CLIA Number: 11D2075869

Address:
210 HANNAHS MILL RD
THOMASTON, GA
ZIP 30286
Phone: (706) 938-0990
Get Directions

ZOE CENTER FOR PEDIATRIC & ADOLESCENT HEALTH, LLC is an adolescent medicine pediatrics in Thomaston, GA. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. ZOE CENTER FOR PEDIATRIC & ADOLESCENT HEALTH, LLC NPI is 1053684936. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

210 HANNAHS MILL RD
THOMASTON, GA
ZIP 30286-801
Phone: (706) 938-0990

The provider's authorized official is Stephanie Kong .
The authorized official title is Owner and has the following contact phone number (706) 938-0990.

The CLIA number assigned to this NPI record is 11D2075869 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/22/2012 and was last updated on 3/30/2020.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2080A0000X	Pediatrics	Adolescent Medicine	39388	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	003122332A	MEDICAID	GEORGIA

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: 5/5/2024

NPI Synchronization or Removal

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