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Organization
CARTERSVILLE PEDIATRIC ASSOCIATES
Active
Organization
CARTERSVILLE PEDIATRIC ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM R PAYNE MD (CFO)
(770) 386-3011
Entity
Organization
Contact information
Practice address
958 JOE FRANK HARRIS PKWY SE, SUITE 101, CARTERSVILLE, GA 30120-2174
(770) 386-3011
(770) 386-9451
Mailing address
PO BOX 200429, CARTERSVILLE, GA 30120-9008
(770) 386-3011
(770) 386-9451
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0003129535A
—
GA
05
—
00214475D
—
GA
05
—
003174076A
—
GA
05
—
00328413D
—
GA
05
—
00852024G
—
GA
Enumeration date
03/22/2007
Last updated
12/02/2016
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