Pedigo, Tara K

Pedigo, Tara K is an individual health care provider with primary practice located at 1120 15Th St , Augusta GA 30912. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Pedigo, Tara K can be contacted via phone (706) 721-8623.

Contact Information

Primary practice address
1120 15Th St Augusta GA 30912
Fax: (706) 721-1459
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 38825 Tennessee

Profile Details

NPI number 1689669699
LBN Legal business name Pedigo, Tara K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2005
Last updated Nov 5th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689669699 NPPES
Tennessee MEDICAID 3894808

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