Jefferson Park Pediatrics P C

NPI #1629263181 in Fort Wayne, Indiana

Provider Information

NPI Number: 1629263181
Entity Type: Organization
Organization Name: Jefferson Park Pediatrics P C
Primary Specialty: Pediatrics
Enumeration Date: Sep 7, 2007
Last Updated: Apr 23, 2025

Practice Location

Address: 3919 W JEFFERSON BLVD STE 1
City: Fort Wayne
State: Indiana
ZIP Code: 46804-6811
Phone: (260) 436-7722

Authorized Official

Name: DR. GIRIDHAR RAO VEERULA, MD
Title: OWNER
Phone: (260) 436-7722

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X
Integrative Medicine	202D00000X
Dermatology	207N00000X
Family Medicine	207Q00000X
Pediatrics	208000000X	Primary

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