Kids Avenue Pediatrics LLC

NPI #1801057609 in College Park, Georgia

Provider Information

NPI Number: 1801057609
Entity Type: Organization
Organization Name: Kids Avenue Pediatrics LLC
Primary Specialty: Pediatrics
Enumeration Date: Jun 24, 2008
Last Updated: Jun 24, 2008

Practice Location

Address: 1720 PHOENIX BLVD
Address 2: SUITE900
City: College Park
State: Georgia
ZIP Code: 30349-5594
Phone: (770) 909-8007

Authorized Official

Name: PHYLLIS STEMBRIDGE
Title: PRACTICE MANAGER
Phone: (770) 909-8007

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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