Kaleidoscope Pediatrics Pc
Pediatric Adolescent Medicine
Kaleidoscope Pediatrics Pc is a Marietta, Georgia based Pediatric center with medical specialization in
Pediatric Adolescent Medicine.
It is located at
1523 Johnson Ferry Rd, Suite 150, Marietta, Georgia - 30062-6438. They can be contacted on phone at
770-509-1234.
NPI number (Unique professional ID) for Kaleidoscope Pediatrics Pc is
1407045495 which was assigned by NPPES on 16 Oct, 2007 and it was last updated on 16 Oct, 2007.
Kaleidoscope Pediatrics Pc specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Kaleidoscope Pediatrics Pc basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Kaleidoscope Pediatrics Pc |
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Business Address:
Kaleidoscope Pediatrics Pc 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 : | 1523 Johnson Ferry Rd, Suite 150
Marietta, GA, 30062-6438
United States |
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| Phone Number : | 770-509-1234 |
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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 : | 1407045495 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 16 Oct, 2007 |
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| Last Updated On : | 16 Oct, 2007 |
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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 : | Susangail Staviss |
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| Authorized Official Credential : | MD |
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| Official Title or Position : | PRESIDENT |
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| Phone Number : | 770-509-1234 |
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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 Kaleidoscope Pediatrics Pc are as mentioned. Primary taxonomy code for Kaleidoscope Pediatrics Pc is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | | |
Legacy Identifiers:
Other legacy medical identifiers of Kaleidoscope Pediatrics Pc such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 52478249004 | Other | GA | BLUE CROSS BLUE SHIELD |
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 : | 1523 Johnson Ferry Rd, Suite 150
Marietta, GA, 30062-6438
United States |
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| Phone Number : | 770-509-1234 |
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Business Location:
Patients can refer following map for directions to
Kaleidoscope Pediatrics Pc practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.