Wellstar Kennestone Pediatric Associates, LLC

NPI #1083660682 in Marietta, Georgia

Provider Information

NPI Number: 1083660682
Entity Type: Organization
Organization Name: Wellstar Kennestone Pediatric Associates, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: WELLSTAR HEALTH SYSTEM, INC.
Primary Specialty: Pediatrics
Enumeration Date: May 25, 2006
Last Updated: Jul 14, 2008

Practice Location

Address: 1371 CHURCH STREET EXT NE
City: Marietta
State: Georgia
ZIP Code: 30060-7913
Phone: (770) 422-8315

Authorized Official

Name: NICOLE ASHE
Title: EXECUTIVE DIRECTOR OF FINANCE
Phone: (770) 792-5261

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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