PREMIER PEDIATRIC GROUP INC. NPI 1093922072

NPI Information

PREMIER PEDIATRIC GROUP INC. is a specialist in Mason, OH. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. PREMIER PEDIATRIC GROUP INC. NPI is 1093922072. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5386 COX SMITH ROAD
SUITE A
MASON, OH
ZIP 45040
Phone: (513) 770-3466
Fax: (513) 770-3467

The provider's authorized official is Bradley Jackson .
The authorized official title is Owner and has the following contact phone number (513) 770-3466.

The enumeration date for this NPI number is 5/17/2007 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:

Other Identifiers

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

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