JEFFERSON PARK PEDIATRICS P C NPI 1629263181

NPI Information

JEFFERSON PARK PEDIATRICS P C is a pediatrics in Fort Wayne, IN. 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. JEFFERSON PARK PEDIATRICS P C NPI is 1629263181. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3919 W JEFFERSON BLVD STE 1
FORT WAYNE, IN
ZIP 46804-811
Phone: (260) 436-7722
Fax: (260) 459-0012

The provider's authorized official is Giridhar Rao Veerula .
The authorized official title is Owner and has the following contact phone number (260) 436-7722.

The enumeration date for this NPI number is 9/7/2007 and was last updated on 1/7/2019.

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

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