PEDIATRIC CLINIC NPI 1649522616

NPI Information

  • NPI: 1649522616
  • Provider Name: PEDIATRIC CLINIC
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • Address: 3604 CUMBERLAND AVE
    MIDDLESBORO, KY
    ZIP 40965
  • Phone: (606) 248-8282

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NPI Details

PEDIATRIC CLINIC is a pediatrics in Middlesboro, KY. 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. PEDIATRIC CLINIC NPI is 1649522616. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3604 CUMBERLAND AVE
MIDDLESBORO, KY
ZIP 40965-614
Phone: (606) 248-8282
Fax: (606) 248-0030

The provider's authorized official is Houshang Khorram .
The authorized official title is Doctor and has the following contact phone number (606) 248-8282.

The enumeration date for this NPI number is 10/15/2012 and was last updated on 10/15/2012.

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
1208000000XPediatrics164526KENTUCKYYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1005628491MEDICAIDVIRGINIA
20095596MEDICAIDTENNESSEE
3C65483MEDICARE UPINKENTUCKY
416526MEDICAIDKENTUCKY

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: 11/21/2025

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