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DV PEDIATRICS LLC NPI 1346368149


NPI Information

NPI: 1346368149
Provider Name: DV PEDIATRICS LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 11D0994179

Address:
2920 MARIETTA HWY
SUITE 142
CANTON, GA
ZIP 30114
Phone: (770) 704-0057
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DV PEDIATRICS LLC is a primary care clinic center in Canton, GA. DV PEDIATRICS LLC NPI is 1346368149. The provider is registered as an organization entity type.

The provider's business location address is:

2920 MARIETTA HWY
SUITE 142
CANTON, GA
ZIP 30114-212
Phone: (770) 704-0057
Fax: (770) 704-0223

The provider's authorized official is Vicki D Knight-mathis .
The authorized official title is Owner and has the following contact phone number (770) 704-0057.

The CLIA number assigned to this NPI record is 11D0994179 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/27/2007 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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QP2300XClinic/CenterPrimary Care047337GEORGIAYes

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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