Provider Demographics
NPI:1801985486
Name:THE PHOENIX CHILDREN'S CENTER, LTD
Entity type:Organization
Organization Name:THE PHOENIX CHILDREN'S CENTER, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:LEDNICKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-263-9550
Mailing Address - Street 1:1661 E CAMELBACK RD STE 170
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-3921
Mailing Address - Country:US
Mailing Address - Phone:602-263-9550
Mailing Address - Fax:602-274-1552
Practice Address - Street 1:1661 E CAMELBACK RD STE 170
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-3921
Practice Address - Country:US
Practice Address - Phone:602-263-9550
Practice Address - Fax:602-274-1552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty