Provider Demographics
NPI:1225417058
Name:ONE FAMILY PEDIATRICS, LLC
Entity Type:Organization
Organization Name:ONE FAMILY PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNDER/PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HIRAL
Authorized Official - Middle Name:
Authorized Official - Last Name:LAVANIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-962-7337
Mailing Address - Street 1:2575 PEACHTREE PKWY
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-7559
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2575 PEACHTREE PKWY
Practice Address - Street 2:SUITE 301
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7559
Practice Address - Country:US
Practice Address - Phone:678-962-7337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA062412208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty