Performance Pediatrics and Sports Medicine, LLC

NPI #1295081321 in Bogart, Georgia

Provider Information

NPI Number
1295081321
Entity Type
Organization
Organization Name
Performance Pediatrics and Sports Medicine, LLC
Primary Specialty
Pediatrics - Sports Medicine
Enumeration Date
Jul 26, 2012
Last Updated
Jul 26, 2012

Practice Location

Address
1181 LANGFORD DR
Address 2
BLDG 200-101
City
Bogart
State
Georgia
ZIP Code
30622-2542
Phone
(706) 207-6694

Authorized Official

Name
DR. TARA ANN MERRITT, M.D.
Title
OWNER PHYSICIAN
Phone
(706) 202-3236

Specialties & Taxonomy Codes

Specialty
Internal Medicine
Pediatrics
Pediatrics - Sports MedicineSports Medicine

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