Pediatric Clinic

LBN: Pediatric Clinic
Pediatric Clinic is an health care organization with primary practice located at 3604 Cumberland Ave , Middlesboro KY 40965-2614. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Pediatric Clinic can be contacted via phone (606) 248-8282, or through Khorram, Houshang via phone (606) 248-8282.

Contact Information

Primary practice address
3604 Cumberland Ave Middlesboro KY 40965-2614
Phone: (606) 248-8282
Fax: (606) 248-0030
Website:
Map and Directions
Authorized official contact:
Name: Khorram, Houshang Doctor of Medicine (MD)
Phone: (606) 248-8282

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 164526 Kentucky

Profile Details

NPI number 1649522616
LBN Legal business name Pediatric Clinic
DBA Doing business as
Authorized official Khorram, Houshang Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 15th, 2012
Last updated Oct 15th, 2012 - about 12 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 1649522616 NPPES
Virginia MEDICAID 005628491
Virginia MEDICAID 0095596
Virginia MEDICAID 16526

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