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LIFE CYCLE PEDIATRICS NPI 1063688224


NPI Information

NPI: 1063688224
Provider Name: LIFE CYCLE PEDIATRICS
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
107B UPPER RIVERDALE RD SW
RIVERDALE, GA
ZIP 30274
Phone: (770) 692-2800
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LIFE CYCLE PEDIATRICS is a pediatrics in Riverdale, 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. LIFE CYCLE PEDIATRICS NPI is 1063688224. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

107B UPPER RIVERDALE RD SW
RIVERDALE, GA
ZIP 30274-540
Phone: (770) 692-2800
Fax: (770) 692-2804

The provider's authorized official is Dorsey Norwood .
The authorized official title is Physician and has the following contact phone number (770) 692-2800.

The enumeration date for this NPI number is 5/7/2008 and was last updated on 5/7/2008.


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
1208000000XPediatrics046192GEORGIAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1894980142AMEDICAIDGEORGIA

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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