DAHLONEGA PEDIATRIC & ADOLESCENT MEDICINE NPI 1922127851

NPI Information

NPI: 1922127851
Provider Name: DAHLONEGA PEDIATRIC & ADOLESCENT MEDICINE
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 11D1022388

Address:
1055 GROVE ST N
DAHLONEGA, GA
ZIP 30533
Phone: (706) 864-6700
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DAHLONEGA PEDIATRIC & ADOLESCENT MEDICINE is a primary care clinic center in Dahlonega, GA. DAHLONEGA PEDIATRIC & ADOLESCENT MEDICINE NPI is 1922127851. The provider is registered as an organization entity type.

The provider's business location address is:

1055 GROVE ST N
DAHLONEGA, GA
ZIP 30533-876
Phone: (706) 864-6700
Fax: (706) 864-2599

The provider's authorized official is Shannon Locke .
The authorized official title is Office Manager and has the following contact phone number (706) 864-6700.

The CLIA number assigned to this NPI record is 11D1022388 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/29/2007 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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	033810	GEORGIA	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: 5/5/2024

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