Jefferson Park Pediatrics P C
Pediatrics
Jefferson Park Pediatrics P C is a Fort Wayne, Indiana based Pediatric center with medical specialization in
General Pediatrics.
It is located at
3919 W Jefferson Blvd Ste 1, Fort Wayne, Indiana - 46804-6811. They can be contacted on phone at
260-436-7722 and fax number 260-459-0012.
NPI number (Unique professional ID) for Jefferson Park Pediatrics P C is
1629263181 which was assigned by NPPES on 07 Sep, 2007 and it was last updated on 07 Jan, 2019.
Jefferson Park Pediatrics P C is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Jefferson Park Pediatrics P C basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Jefferson Park Pediatrics P C |
|---|
Business Address:
Jefferson Park Pediatrics P C address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 3919 W Jefferson Blvd Ste 1
Fort Wayne, IN, 46804-6811
United States |
|---|
| Phone Number : | 260-436-7722 |
|---|
| Fax Number : | 260-459-0012 |
|---|
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1629263181 |
|---|
| NPI Entity Type : | Organization |
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| First Enrolment Date : | 07 Sep, 2007 |
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| Last Updated On : | 07 Jan, 2019 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Giridharrao Veerula |
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| Authorized Official Credential : | MD |
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| Official Title or Position : | OWNER |
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| Phone Number : | 260-436-7722 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Jefferson Park Pediatrics P C are as mentioned. Primary taxonomy code for Jefferson Park Pediatrics P C is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 174400000X | Specialist | No | | |
| 207N00000X | Dermatology | No | | |
| 208000000X | Pediatrics | Yes | | |
Legacy Identifiers:
Other legacy medical identifiers of Jefferson Park Pediatrics P C such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 200262620 | MEDICAID | IN | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 3919 W Jefferson Blvd Ste 1
Fort Wayne, IN, 46804-6811
United States |
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| Phone Number : | 260-436-7722 |
|---|
| Fax Number : | 260-459-0012 |
|---|
Business Location:
Patients can refer following map for directions to
Jefferson Park Pediatrics P C practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.