Grace Pediatric Clinic, P.A.

LBN: Grace Pediatric Clinic, P.A.
Grace Pediatric Clinic, P.A. is an health care organization with primary practice located at 2401 Tuckaseegee Rd , Charlotte NC 28208-4058. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Grace Pediatric Clinic, P.A. can be contacted via phone (704) 409-3000, or through Tokunboh, Julius via phone (709) 409-3000.

Contact Information

Primary practice address
2401 Tuckaseegee Rd Charlotte NC 28208-4058
Phone: (704) 409-3000
Fax: (704) 409-2382
Website:
Map and Directions
Authorized official contact:
Name: Tokunboh, Julius Doctor of Medicine (MD)
Phone: (709) 409-3000

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 9800405 North Carolina

Profile Details

NPI number 1447307384
LBN Legal business name Grace Pediatric Clinic, P.A.
DBA Doing business as
Authorized official Tokunboh, Julius Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 4th, 2007
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 1447307384 NPPES
North Carolina MEDICAID 891359N

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