Provider Demographics
NPI:1013026020
Name:SPRING CREEK PEDIATRICS, INC.
Entity Type:Organization
Organization Name:SPRING CREEK PEDIATRICS, INC.
Other - Org Name:MCLEAN MEDICAL SERVICES, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:STEGALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-892-3400
Mailing Address - Street 1:929 SPRING CREEK RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37412-3964
Mailing Address - Country:US
Mailing Address - Phone:423-892-3400
Mailing Address - Fax:423-892-8266
Practice Address - Street 1:929 SPRING CREEK RD
Practice Address - Street 2:SUITE 206
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37412-3964
Practice Address - Country:US
Practice Address - Phone:423-892-3400
Practice Address - Fax:423-892-8266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty