Provider Demographics
NPI:1962469304
Name:CHILDRENS ORTHOPEDIC CENTER
Entity Type:Organization
Organization Name:CHILDRENS ORTHOPEDIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:ATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-272-0726
Mailing Address - Street 1:1011 HIOAKS RD
Mailing Address - Street 2:STE D
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225
Mailing Address - Country:US
Mailing Address - Phone:804-272-0726
Mailing Address - Fax:
Practice Address - Street 1:1011 HIOAKS RD
Practice Address - Street 2:STE D
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225
Practice Address - Country:US
Practice Address - Phone:804-272-0726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101047136208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F08819Medicare UPIN
VA006400744Medicare ID - Type Unspecified