# PEDIATRICS PRIMARY CARE CLINIC LLC

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

## Provider details

- **NPI number:** 1962130443
- **Authorized official:** KELLY COLLINS NURSE PRACTITIONER (OWNER)
- **Authorized official phone:** (318) 794-2428

## Contact information

- **Practice address:** 11098 HIGHWAY 165 S, FOREST HILL, LA 71430-9789
- **Practice address phone:** (318) 368-1236
- **Mailing address:** PO BOX 457, FOREST HILL, LA 71430-0457
- **Mailing address phone:** (318) 794-2428

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/11/2022
- **Last updated:** 01/18/2024