Kid Station Pediatrics P.c

NPI #1720213952 in Lagrange, Georgia

Provider Information

NPI Number: 1720213952
Entity Type: Organization
Organization Name: Kid Station Pediatrics P.c
Primary Specialty: Pediatrics
Enumeration Date: May 18, 2009
Last Updated: Feb 2, 2012

Practice Location

Address: 301 MEDICAL DR
Address 2: SUITE 504
City: Lagrange
State: Georgia
ZIP Code: 30240-4144
Phone: (706) 882-5437

Authorized Official

Name: KALYANI ANGAMPALLY RAJEEV, M.D
Title: OWNER
Phone: (678) 481-7879

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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