Provider Demographics
NPI:1558411520
Name:KIDSFIRST PEDIATRICS, INC.
Entity Type:Organization
Organization Name:KIDSFIRST PEDIATRICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCGILL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:423-798-6630
Mailing Address - Street 1:5000 MONARCH PT
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-4275
Mailing Address - Country:US
Mailing Address - Phone:423-798-6630
Mailing Address - Fax:423-798-6633
Practice Address - Street 1:5000 MONARCH PT
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4275
Practice Address - Country:US
Practice Address - Phone:423-798-6630
Practice Address - Fax:423-798-6633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO0000001255208000000X
363A00000X
TNAPN0000007290363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty