DECATUR PEDIATRIC GROUP, PA - NPI 1619029592 - Pediatrics in Clarkston, GA

Q: What is Decatur Pediatric Group, PA's NPI number?

The NPI number for Decatur Pediatric Group, PA is 1619029592. It was assigned to this organization in the NPPES registry on January 18, 2007.

Q: What is Decatur Pediatric Group, PA's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

On this page

About Decatur Pediatric Group, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DECATUR PEDIATRIC GROUP, PA (NPI 1619029592) is a healthcare organization registered as a pediatrics in Clarkston, Georgia and active in the NPI registry since January 2007. The organization lists Lynette R Wilson-phillips, President, as its authorized official.

NPPES Registry Identity

NPI1619029592

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameDECATUR PEDIATRIC GROUP, PA

Location Address4112 E PONCE DE LEON AVEClarkston, GA 30021-1817

Mailing Address4112 E Ponce De Leon AveClarkston, GA 30021-1817 · (404) 296-7133 · Fax (404) 296-7211

Phone(404) 296-7133

Fax(404) 296-7211

Organization SubpartNo

Authorized OfficialLynette R Wilson-phillipsPresident · (404) 296-7133

Enumeration DateJanuary 18, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1619029592 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in GA · 038132

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

4112 E PONCE DE LEON AVE, Clarkston, GA 30021

Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LYNETTE ROCHELLE WILSON-PHILLIPS M.D.

Pediatrics