Organization
CRIDER JOHNSON PEDIATRICS PSC
Active
Other names
jyothi mettu md psc
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDY ROBINSON (MANAGER)
(606) 437-1008
Entity
Organization
Contact information
Practice address
387 TOWN MOUNTAIN RD, SUITE 202, PIKEVILLE, KY 41501-1640
(606) 437-1056
(606) 437-5040
Mailing address
387 TOWN MOUNTAIN RD, SUITE 202, PIKEVILLE, KY 41501-1640
(606) 437-1056
(606) 437-5040
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100207560
—
KY
Enumeration date
09/01/2006
Last updated
08/29/2012
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