| Vibrant Kids Pediatrics, Llc | |
|
10 Market Square Way Ste 100 Newnan GA 30265-6078 | |
| (678) 423-5560 | |
| (678) 423-5563 |
| Full Name | Vibrant Kids Pediatrics, Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 10 Market Square Way Ste 100, Newnan, Georgia |
| Authorized Official Name and Position | Jill Burnett Dickerson (MANAGER) |
| Authorized Official Contact | 6784235560 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vibrant Kids Pediatrics, Llc 87 Tapestry Ln Newnan GA 30265-5649 Ph: (678) 423-5560 | Vibrant Kids Pediatrics, Llc 10 Market Square Way Ste 100 Newnan GA 30265-6078 Ph: (678) 423-5560 |
| NPI Number | 1811241417 |
|---|---|
| Provider Enumeration Date | 11/04/2012 |
| Last Update Date | 11/04/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811241417 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 061061 (Georgia) | Primary |
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