# THE CHILDREN'S CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518021237
- **Authorized official:** DR. PEDRO SAGMIT BAULA JR. M.D. (PHYSICAN)
- **Authorized official phone:** (270) 769-6888

## Contact information

- **Practice address:** 596 WESTPORT RD, ELIZABETHTOWN, KY 42701-2949
- **Practice address phone:** (270) 679-6888
- **Practice address fax:** (270) 769-9199
- **Mailing address:** 75 WOODSBEND RD, ELIZABETHTOWN, KY 42701-9502
- **Mailing address phone:** (270) 737-4709

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 363L00000X | KY | Yes |
| 174400000X | Specialist | — | KY | — |

## Other

- **Enumeration date:** 12/20/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1110486 | — | KY |