Provider Demographics
NPI:1508975624
Name:CHILDREN'S MEDICINE, P.C.
Entity Type:Organization
Organization Name:CHILDREN'S MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-921-7386
Mailing Address - Street 1:3685 LAWRENCEVILLE HWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-4107
Mailing Address - Country:US
Mailing Address - Phone:770-921-7386
Mailing Address - Fax:770-381-6013
Practice Address - Street 1:3685 LAWRENCEVILLE HWY
Practice Address - Street 2:SUITE 100
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-4107
Practice Address - Country:US
Practice Address - Phone:770-921-7386
Practice Address - Fax:770-381-6013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty