Provider Demographics
NPI:1427217322
Name:PEDIATRICS VILLAGE, P.C.
Entity Type:Organization
Organization Name:PEDIATRICS VILLAGE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWER
Authorized Official - Prefix:DR
Authorized Official - First Name:W
Authorized Official - Middle Name:STEEN
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-487-1519
Mailing Address - Street 1:2002 COMMERCE DR N
Mailing Address - Street 2:SUITE A
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-3553
Mailing Address - Country:US
Mailing Address - Phone:770-487-1519
Mailing Address - Fax:
Practice Address - Street 1:2002 COMMERCE DR N
Practice Address - Street 2:SUITE A
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-3553
Practice Address - Country:US
Practice Address - Phone:770-487-1519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty