| Kids Doc Pediatrics | |
|
3100 Five Forks Trickum Rd Sw Ste 204 Lilburn GA 30047-1887 | |
| (770) 978-7701 | |
| (770) 978-7822 |
| Full Name | Kids Doc Pediatrics |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 3100 Five Forks Trickum Rd Sw Ste 204, Lilburn, Georgia |
| Authorized Official Name and Position | Akber H Hashim (PRESIDENT) |
| Authorized Official Contact | 7709787701 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kids Doc Pediatrics 3100 Five Forks Trickum Rd Sw Ste 204 Lilburn GA 30047-1887 Ph: (770) 978-7701 | Kids Doc Pediatrics 3100 Five Forks Trickum Rd Sw Ste 204 Lilburn GA 30047-1887 Ph: (770) 978-7701 |
| NPI Number | 1932374618 |
|---|---|
| Provider Enumeration Date | 04/24/2008 |
| Last Update Date | 04/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932374618 | NPI | - | NPPES |
| 000809817N | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 043638 (Georgia) | Primary |
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