Provider Demographics
NPI:1598930141
Name:PINNACLE PEDIATRICS PC
Entity Type:Organization
Organization Name:PINNACLE PEDIATRICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZENIA
Authorized Official - Middle Name:ISADORA
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-944-0060
Mailing Address - Street 1:5604 WENDY BAGWELL PKWY
Mailing Address - Street 2:SUITE 1111
Mailing Address - City:HIRAM
Mailing Address - State:GA
Mailing Address - Zip Code:30141-7813
Mailing Address - Country:US
Mailing Address - Phone:678-944-0060
Mailing Address - Fax:678-944-0070
Practice Address - Street 1:5604 WENDY BAGWELL PKWY
Practice Address - Street 2:SUITE 1111
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-7813
Practice Address - Country:US
Practice Address - Phone:678-944-0060
Practice Address - Fax:678-944-0070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056055208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty