| Kids & Teens Primary Healthcare | |
|
2785 Lawrenceville Hwy Suite 207 Decatur GA 30033 | |
| (770) 621-0245 | |
| (770) 621-0819 |
| Full Name | Kids & Teens Primary Healthcare |
|---|---|
| Speciality | Pediatrics |
| Location | 2785 Lawrenceville Hwy, Decatur, Georgia |
| Authorized Official Name and Position | Byron Cedric Cotton (PHYSICIAN/OWNER) |
| Authorized Official Contact | 7706210245 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kids & Teens Primary Healthcare 2785 Lawrenceville Hwy Suite 207 Decatur GA 30033 Ph: (770) 621-0245 | Kids & Teens Primary Healthcare 2785 Lawrenceville Hwy Suite 207 Decatur GA 30033 Ph: (770) 621-0245 |
| NPI Number | 1346419710 |
|---|---|
| Provider Enumeration Date | 02/29/2008 |
| Last Update Date | 09/01/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346419710 | NPI | - | NPPES |
| 000679731N | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0000X | Family Medicine - Adolescent Medicine | 041098 (Georgia) | Secondary |
| 208000000X | Pediatrics | 041098 (Georgia) | Primary |
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