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Abc Pediatrics

Organization Active NPI Pediatrics Physician · Fayetteville, GA

NPI 1902923964 · NPPES record last updated Feb 28, 2024

Key facts

NPI
1902923964
Entity type
Organization (NPI type 2)
Primary specialty
Pediatrics Physician 208000000X
Legal business name
ABC PEDIATRICS
Practice address
735 Glynn St S
Fayetteville, GA 30214-2049
Phone
(770) 461-4126
Fax
(770) 461-8852
NPI assigned
Mar 23, 2007
Organization subpart
No

Authorized official

Name
Leslie Deanne Smoak, MD
Title
Physician Owner
Phone
(770) 461-4126

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0937556Abc Pediatrics PC
735 Glynn Street, South, Fayetteville, GA 30214		Certificate of waiverJul 31, 2026

National Provider Directory

Locations

735 Glynn St S
Fayetteville, GA 30214
Phone (770) 461-4126

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 208000000X Yes

Addresses

Primary practice location

735 Glynn St S
Fayetteville, GA 30214-2049

Mailing address

735 Glynn St S
Fayetteville, GA 30214-2049
Phone (770) 461-4126

Other providers in Fayetteville, GA

All providers in Fayetteville, GA · Pediatrics Physician in Georgia

Sources for this page

Verify at the official NPI Registry.