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COLLIERVILLE PEDIATRICS LLC NPI 1326229345


NPI Information

NPI: 1326229345
Provider Name: COLLIERVILLE PEDIATRICS, LLC
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
2028 W POPLAR AVE
SUITE 112
COLLIERVILLE, TN
ZIP 38017
Phone: (901) 854-5455
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COLLIERVILLE PEDIATRICS, LLC is a pediatrics in Collierville, TN. 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. COLLIERVILLE PEDIATRICS, LLC NPI is 1326229345. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2028 W POPLAR AVE
SUITE 112
COLLIERVILLE, TN
ZIP 38017-618
Phone: (901) 854-5455
Fax: (901) 377-7309

The provider's authorized official is Jaya Venkataraman .
The authorized official title is Md/president and has the following contact phone number (901) 854-5455.

The enumeration date for this NPI number is 11/19/2007 and was last updated on 11/19/2007.


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
1208000000XPediatrics38751TENNESSEEYes

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
1F99456MEDICARE UPINTENNESSEE

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: 11/14/2023

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