Josephine T Ediale
M.D. | Pediatrics | Female
Josephine T Ediale, M.D. is a Villa Rica, Georgia based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Josephine T Ediale is
626 Dallas Hwy, Villa Rica, Georgia - 30180-1209. She can be contacted on phone at
770-459-9378 and fax number 770-459-8613.
Josephine T Ediale is a sole proprietor of her business.
NPI number (Unique professional ID) for Josephine T Ediale is
1902880842 which was assigned by NPPES on 05 Dec, 2005 and it was last updated on 07 Oct, 2014.
Josephine T Ediale license number is
050514 for Pediatrics (208000000X) in Georgia.
Josephine T Ediale 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:
Josephine T Ediale basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
|---|
| Provider Name : | Josephine T Ediale |
|---|
| Credential : | M.D. |
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| Gender : | Female |
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Business Address:
Josephine T Ediale 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 : | 626 Dallas Hwy
Villa Rica, GA, 30180-1209
United States |
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| Phone Number : | 770-459-9378 |
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| Fax Number : | 770-459-8613 |
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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 : | 1902880842 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 05 Dec, 2005 |
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| Last Updated On : | 07 Oct, 2014 |
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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 Josephine T Ediale are as mentioned. Primary taxonomy code for Josephine T Ediale, M.D. is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | 050514 | GA |
Legacy Identifiers:
Other legacy medical identifiers of Josephine T Ediale such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 01065140 | Other | GA | AMERIGROUP |
| 000922732 | Other | GA | PEACHSTATE |
| 305728 | Other | GA | WELLCARE |
| 000922732C | MEDICAID | GA | |
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 : | 4480 Blue Ridge Drive
Douglasville, GA, 30135-1800
United States |
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| Phone Number : | 770-459-9378 |
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| Fax Number : | 770-459-8613 |
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Business Location:
Patients can refer following map for directions to
Josephine T Ediale practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.