Eatonton Pediatrics
Organization Active NPI Pediatrics Physician · Eatonton, GA
NPI 1902064918 · NPPES record last updated May 27, 2008
Key facts
- NPI
- 1902064918
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 042781 (GA)
- Legal business name
- EATONTON PEDIATRICS
- Practice address
- 116 Sparta Hwy
Eatonton, GA 31024-8484 - Phone
- (706) 923-0904
- Fax
- (706) 923-0905
- NPI assigned
- May 27, 2008
- Organization subpart
- No
Authorized official
- Name
- Muneer Al-Hakim
- Title
- M.D.
- Phone
- (706) 923-0904
Practitioners 1
-
Muneer Al-Hakim, M.D.
National Provider Directory
Locations
1015 Fernwood Dr
Milledgeville, GA 31061
Phone (478) 452-3835
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | 042781 | GA | Yes |
Addresses
Primary practice location
116 Sparta Hwy
Eatonton, GA 31024-8484
Mailing address
PO Box 3009
Eatonton, GA 31024-3009
Phone (706) 923-0904
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 611384188A | Medicaid | GA | |
| 733076132A | Medicaid | GA |
Other providers in Eatonton, GA
- Joseph Anthony D'Agostino
- Rita Daniel
- Verntavius Jaymel Denham
- Eatonton Dental Sleep Solutions LLC
- Eatonton Facility Development Company, LLC
- Eddie Richardson Jr MD PC
- Ellington Eyecare PLLC
- Michael Wayne Evans Jr.
- Family Practice & Surgery
- Faulk Medical Services, Inc.
All providers in Eatonton, GA · Pediatrics Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.