Organization · Type 2 NPI
Pediatric Professionals
Specialist · Jacksboro, TN
NPI number
1518112911
Active
Practice location
136 Mountain Perkins Lane, Suite 2
Jacksboro, TN 37757
Mailing address
PO Box 440305, Suite 2
Nashville, TN 37244-0305
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | 30258 (TN) |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Another provider at this address
About NPI 1518112911
Pediatric Professionals's National Provider Identifier is 1518112911, issued on Nov 26, 2008. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Jacksboro, TN. The record was last updated on Mar 12, 2009.