Northside Pediatrics Psc

NPI #1295894137 in Glasgow, Kentucky

Provider Information

NPI Number: 1295894137
Entity Type: Organization
Organization Name: Northside Pediatrics Psc
Primary Specialty: Pediatrics
Enumeration Date: Dec 6, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 290 OLD JACKSON HWY 31E LOOP
City: Glasgow
State: Kentucky
ZIP Code: 42141-9089
Phone: (270) 678-5740

Authorized Official

Name: SANDRA DOTSON MOSS, M.D.
Title: PRESIDENT
Phone: (270) 678-5740

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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