Provider Demographics
NPI:1972658797
Name:ALL CHILDREN'S PEDIATRICS
Entity Type:Organization
Organization Name:ALL CHILDREN'S PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-522-3870
Mailing Address - Street 1:1875 N PARIS AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ROYAL
Mailing Address - State:SC
Mailing Address - Zip Code:29935-2029
Mailing Address - Country:US
Mailing Address - Phone:843-522-3870
Mailing Address - Fax:843-522-0691
Practice Address - Street 1:1875 N PARIS AVE
Practice Address - Street 2:
Practice Address - City:PORT ROYAL
Practice Address - State:SC
Practice Address - Zip Code:29935-2029
Practice Address - Country:US
Practice Address - Phone:843-522-3870
Practice Address - Fax:843-522-0691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty