Organization
KIDDIE WEST PEDIATRICS INC
Active
Organization
KIDDIE WEST PEDIATRICS INC
Active
Other names
Kiddie West Pediatric Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL R BACKES D.O. (PRESIDENT)
(614) 851-7337
Entity
Organization
Contact information
Practice address
4766 W BROAD ST, COLUMBUS, OH 43228-1613
(614) 851-7337
(614) 851-0080
Mailing address
4766 W BROAD ST, COLUMBUS, OH 43228-1613
(614) 851-7337
(614) 851-0080
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
34-00-2237
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2356954
—
OH
Enumeration date
03/16/2006
Last updated
07/16/2009
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