KIDS FIRST PEDIATRIC GROUP LLC NPI 1720117989

NPI Information

  • NPI: 1720117989
  • Provider Name: KIDS FIRST PEDIATRIC GROUP, LLC
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • CLIA Number: 11D0969768
  • Address: 1045 SOUTHCREST DR
    SUITE 110
    STOCKBRIDGE, GA
    ZIP 30281
  • Phone: (770) 507-2212

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NPI Details

KIDS FIRST PEDIATRIC GROUP, LLC is a pediatrics in Stockbridge, GA. 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. KIDS FIRST PEDIATRIC GROUP, LLC NPI is 1720117989. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1045 SOUTHCREST DR
SUITE 110
STOCKBRIDGE, GA
ZIP 30281-113
Phone: (770) 507-2212
Fax: (770) 507-2213

The provider's authorized official is Elaine C Youngblood .
The authorized official title is Physican Owner and has the following contact phone number (770) 506-2212.

The CLIA number assigned to this NPI record is 11D0969768 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/5/2007 and was last updated on 1/30/2013.

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
1208000000XPediatricsYes

What is NPI?

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This page was last updated on: 11/21/2025

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