Provider Demographics
NPI:1427018894
Name:THOMASVILLE-ARCHDALE PEDIATRICS, PLLC
Entity Type:Organization
Organization Name:THOMASVILLE-ARCHDALE PEDIATRICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CLINT
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-476-9446
Mailing Address - Street 1:200 ARTHUR DR
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27360-6275
Mailing Address - Country:US
Mailing Address - Phone:336-475-2348
Mailing Address - Fax:336-475-2100
Practice Address - Street 1:200 ARTHUR DR
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-6275
Practice Address - Country:US
Practice Address - Phone:336-475-2348
Practice Address - Fax:336-475-2100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty