Provider Demographics
NPI:1770248775
Name:DANVILLE PEDIATRICS MEDICAL GROUP PLLC
Entity type:Organization
Organization Name:DANVILLE PEDIATRICS MEDICAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:STRINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-236-1080
Mailing Address - Street 1:303 S 4TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-2091
Mailing Address - Country:US
Mailing Address - Phone:859-236-1080
Mailing Address - Fax:859-236-1862
Practice Address - Street 1:1180 GLENSBORO RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:KY
Practice Address - Zip Code:40342-9034
Practice Address - Country:US
Practice Address - Phone:502-598-3042
Practice Address - Fax:502-598-3184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-03
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health