Organization
LIFE CYCLE PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DORSEY NORWOOD MD (PHYSICIAN)
(770) 692-2800
Entity
Organization
Contact information
Practice address
107B UPPER RIVERDALE RD SW, RIVERDALE, GA 30274-2540
(770) 692-2800
(770) 692-2804
Mailing address
2739 FELTON DR, EAST POINT, GA 30344-3603
(404) 766-8371
(404) 767-3926
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
046192
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
894980142A
—
GA
Enumeration date
05/07/2008
Last updated
05/07/2008
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