Premier Childrens Healthcare Pc | |
1029 West Main St Suite M Lebanon TN 37087 | |
(615) 453-9492 | |
(615) 453-9498 |
Full Name | Premier Childrens Healthcare Pc |
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Speciality | Pediatrics |
Location | 1029 West Main St, Lebanon, Tennessee |
Authorized Official Name and Position | Stacy Kellum (OFFICE MANAGER) |
Authorized Official Contact | 6154539492 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Premier Childrens Healthcare Pc 1029 West Main St Suite M Lebanon TN 37087 Ph: (615) 453-9492 | Premier Childrens Healthcare Pc 1029 West Main St Suite M Lebanon TN 37087 Ph: (615) 453-9492 |
NPI Number | 1851491609 |
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Provider Enumeration Date | 09/22/2006 |
Last Update Date | 04/08/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1851491609 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
207V00000X | Obstetrics & Gynecology | (* (Not Available)) | Secondary |
208000000X | Pediatrics | (* (Not Available)) | Primary |
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