Provider Demographics
NPI:1225163736
Name:A KIDS WORLD PEDIATRICS
Entity Type:Organization
Organization Name:A KIDS WORLD PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:JEFFERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-460-2131
Mailing Address - Street 1:288 HIGHWAY 314
Mailing Address - Street 2:SUITE A
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-7830
Mailing Address - Country:US
Mailing Address - Phone:770-460-2131
Mailing Address - Fax:770-460-5011
Practice Address - Street 1:288 HIGHWAY 314
Practice Address - Street 2:SUITE A
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7830
Practice Address - Country:US
Practice Address - Phone:770-460-2131
Practice Address - Fax:770-460-5011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty