Northside Children's Pediatric Center, Llc
Pediatrics
Northside Children's Pediatric Center, Llc is a Canton, Georgia based Pediatric center with medical specialization in
General Pediatrics. Northside Children's Pediatric Center, Llc is also known as
Northside Children's Pediatrics Center, Pc.
It is located at
391 East Main Street, Historic Hawkins Building, Canton, Georgia - 30114-2712. They can be contacted on phone at
770-720-6963 and fax number 770-720-6965.
NPI number (Unique professional ID) for Northside Children's Pediatric Center, Llc is
1396945515 which was assigned by NPPES on 25 Jul, 2007 and it was last updated on 24 Jan, 2012.
Northside Children's Pediatric Center, Llc license number is
GA 54532 for Pediatrics (208000000X) in Georgia.
Northside Children's Pediatric Center, Llc 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:
Northside Children's Pediatric Center, Llc basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Northside Children's Pediatric Center, Llc |
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| Other Name : | Northside Children's Pediatrics Center, Pc |
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Business Address:
Northside Children's Pediatric Center, Llc 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 : | 391 East Main Street, Historic Hawkins Building
Canton, GA, 30114-2712
United States |
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| Phone Number : | 770-720-6963 |
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| Fax Number : | 770-720-6965 |
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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 : | 1396945515 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 25 Jul, 2007 |
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| Last Updated On : | 24 Jan, 2012 |
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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 : | Stephanieheaton Anderson |
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| Authorized Official Credential : | DNP, PNP, RNC |
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| Official Title or Position : | RN-PNP, MEMBER, AND (SPOUSE OF MD) |
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| Phone Number : | 770-720-6963 |
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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 Northside Children's Pediatric Center, Llc are as mentioned. Primary taxonomy code for Northside Children's Pediatric Center, Llc is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 261QP2300X | Clinic/Center Primary Care | No | GA PHYSICIAN 54532 | GA |
| 208000000X | Pediatrics | Yes | GA 54532 | GA |
Legacy Identifiers:
Other legacy medical identifiers of Northside Children's Pediatric Center, Llc such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 1396945515 | Other | GA | AUTH REPRESENTATIVE: MICHAEL G. ANDERSON, MD, ENTITY ATTENDING PHYSICIAN |
| 629697125A | 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 : | 391 East Main Street, Historic Hawkins Building
Canton, GA, 30114-2712
United States |
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| Phone Number : | 770-720-6963 |
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| Fax Number : | 770-720-6965 |
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Business Location:
Patients can refer following map for directions to
Northside Children's Pediatric Center, Llc practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.