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Organization
CARROLLTON PEDIATRIC CLINIC, P.C.
Active
Organization
CARROLLTON PEDIATRIC CLINIC, P.C.
Active
Other names
Westcare Pediatric and Family Care
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA HALL (OFFICE MANAGER)
(770) 832-1103
Entity
Organization
Contact information
Practice address
410 NEWNAN ST, CARROLLTON, GA 30117-3111
(770) 832-1103
(770) 832-1142
Mailing address
410 NEWNAN ST, CARROLLTON, GA 30117-3111
(770) 832-1103
(770) 832-1142
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11D0934505
CLIA
GA
05
—
300025719A
—
GA
Enumeration date
09/22/2006
Last updated
06/21/2018
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