Provider Demographics
NPI:1164859880
Name:JOINT HEIRS PEDIATRICS LLC
Entity Type:Organization
Organization Name:JOINT HEIRS PEDIATRICS LLC
Other - Org Name:HEALTHY HORIZONS PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ABIMBOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ODUKOYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-675-1263
Mailing Address - Street 1:419 E LINCOLN RD
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902-3716
Mailing Address - Country:US
Mailing Address - Phone:765-864-2400
Mailing Address - Fax:765-864-2401
Practice Address - Street 1:419 E LINCOLN RD
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-3716
Practice Address - Country:US
Practice Address - Phone:765-864-2400
Practice Address - Fax:765-864-2401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-27
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01062399208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty