Amory Pediatric

NPI #1902020639 in Amory, Mississippi

Provider Information

NPI Number: 1902020639
Entity Type: Organization
Organization Name: Amory Pediatric
Primary Specialty: Pediatrics
Enumeration Date: Apr 12, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1107 EARL FRYE BLVD STE 5
City: Amory
State: Mississippi
ZIP Code: 38821-5519
Phone: (662) 257-6705

Authorized Official

Name: CHRIS DEDEAUX
Title: CLINIC ADMINISTRATOR
Phone: (662) 256-7112

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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