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JACKSON PEDIATRICS P.C. NPI 1316158272


NPI Information

NPI: 1316158272
Provider Name: JACKSON PEDIATRICS P.C.

Doing Business As: JACKSON PEDIATRICS PC

Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 53D2203437

Address:
557 E. BROADWAY
557 E. BROADWAY
JACKSON, WY
ZIP 83001
Phone: (307) 733-4627
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JACKSON PEDIATRICS P.C. is a pediatrics in Jackson, WY. 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. JACKSON PEDIATRICS P.C. NPI is 1316158272. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Jackson Pediatrics Pc.

The provider's business location address is:

557 E. BROADWAY
557 E. BROADWAY
JACKSON, WY
ZIP 83001-300
Phone: (307) 733-4627
Fax: (307) 733-5184

The provider's authorized official is James R Little .
The authorized official title is Owner and has the following contact phone number (307) 733-4627.

The CLIA number assigned to this NPI record is 53D2203437 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/24/2007 and was last updated on 10/24/2013.


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
1208000000XPediatrics2242AWYOMINGYes

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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