Provider Demographics
NPI:1366475295
Name:EASTERN PANHANDLE PEDIATRICS, PLLC
Entity Type:Organization
Organization Name:EASTERN PANHANDLE PEDIATRICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:FIKE
Authorized Official - Last Name:ARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-263-8853
Mailing Address - Street 1:2000 PROFESSIONAL CT
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-8758
Mailing Address - Country:US
Mailing Address - Phone:304-263-8853
Mailing Address - Fax:304-263-6178
Practice Address - Street 1:2000 PROFESSIONAL CT
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-8758
Practice Address - Country:US
Practice Address - Phone:304-263-8853
Practice Address - Fax:304-263-6178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty