Provider Demographics
NPI:1992127856
Name:PEDIATRIC ASSOCIATES OF NEWNAN P.C.
Entity type:Organization
Organization Name:PEDIATRIC ASSOCIATES OF NEWNAN P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LAFAYETTE
Authorized Official - Last Name:WHIPPLE
Authorized Official - Suffix:IV
Authorized Official - Credentials:MD
Authorized Official - Phone:770-400-8450
Mailing Address - Street 1:775 POPLAR RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-8300
Mailing Address - Country:US
Mailing Address - Phone:770-400-8450
Mailing Address - Fax:770-400-8451
Practice Address - Street 1:775 POPLAR RD
Practice Address - Street 2:SUITE 150
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-8300
Practice Address - Country:US
Practice Address - Phone:770-400-8450
Practice Address - Fax:770-400-8451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA046279208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty