Child And Adolescent Medical Providers, P.C.

LBN: Child And Adolescent Medical Providers, P.C.
Child And Adolescent Medical Providers, P.C. is an health care organization with primary practice located at 13375 Jones St Ste C , Lavonia GA 30553-1147. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Child And Adolescent Medical Providers, P.C. can be contacted via phone (706) 356-5439, or through Martin, David C via phone (706) 356-5439.

Contact Information

Primary practice address
13375 Jones St Ste C Lavonia GA 30553-1147
Phone: (706) 356-5439
Fax: (706) 356-5897
Website:
Map and Directions
Authorized official contact:
Name: Martin, David C Doctor of Medicine (MD)
Phone: (706) 356-5439

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 047486 Georgia

Profile Details

NPI number 1215093430
LBN Legal business name Child And Adolescent Medical Providers, P.C.
DBA Doing business as
Authorized official Martin, David C Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 29th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215093430 NPPES
Georgia MEDICAID 309143
Georgia Other 52768660
Georgia MEDICAID 85002622G
Georgia MEDICAID 00860219C
Georgia MEDICAID 10056443

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