ACTIVE KIDS PEDIATRICS PC NPI 1629325378

NPI Information

NPI: 1629325378
Provider Name: ACTIVE KIDS PEDIATRICS, PC
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
15215 S 48TH ST
SUITE 110
PHOENIX, AZ
ZIP 85044
Phone: (480) 783-8960
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ACTIVE KIDS PEDIATRICS, PC is a health service clinic center in Phoenix, AZ. ACTIVE KIDS PEDIATRICS, PC NPI is 1629325378. The provider is registered as an organization entity type.

The provider's business location address is:

15215 S 48TH ST
SUITE 110
PHOENIX, AZ
ZIP 85044-142
Phone: (480) 783-8960
Fax: (480) 783-8967

The provider's authorized official is Judith Rosch Barnes Clark .
The authorized official title is Pediatrician, Co-owner and has the following contact phone number (480) 783-8960.

The enumeration date for this NPI number is 8/13/2012 and was last updated on 8/13/2012.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service	A32674	ARIZONA	Yes

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

NPI Synchronization or Removal

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