Dr. Mendoza'S Pediatric And Adolscent

LBN: Dr. Mendoza'S Pediatric And Adolscent
Dr. Mendoza'S Pediatric And Adolscent is an health care organization with primary practice located at 424 Jett Dr , Jackson KY 41339-9621. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as the primary health care specialty. Dr. Mendoza'S Pediatric And Adolscent can be contacted via phone (606) 693-4800, or through Mendoza, Edgar Allen via phone (606) 693-4800.

Contact Information

Primary practice address
424 Jett Dr Jackson KY 41339-9621
Phone: (606) 693-4800
Fax: (606) 693-4825
Website:
Map and Directions
Authorized official contact:
Name: Mendoza, Edgar Allen Doctor of Medicine (MD)
Phone: (606) 693-4800

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 33465 Kentucky

Profile Details

NPI number 1295908101
LBN Legal business name Dr. Mendoza'S Pediatric And Adolscent
DBA Doing business as
Authorized official Mendoza, Edgar Allen Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 11th, 2008
Last updated Jul 10th, 2014 - about 11 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 1295908101 NPPES
Kentucky MEDICAID 31000979

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