Provider Demographics
NPI:1699827030
Name:P.M. PEDIATRICS, LLC
Entity Type:Organization
Organization Name:P.M. PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-648-6483
Mailing Address - Street 1:PO BOX 81147
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37414-8347
Mailing Address - Country:US
Mailing Address - Phone:423-648-6483
Mailing Address - Fax:423-648-6484
Practice Address - Street 1:7446 SHALLOWFORD RD
Practice Address - Street 2:STE 103
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-8815
Practice Address - Country:US
Practice Address - Phone:423-648-6483
Practice Address - Fax:423-648-6484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty