Organization
PHILLIPS PEDIATRICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP O AJAYI MD (PHYSICIAN/OWNER)
(912) 876-6868
Entity
Organization
Contact information
Practice address
455 S MAIN STREET, STE 101, HINESVILLE, GA 31313-4354
(912) 876-6868
(912) 876-6566
Mailing address
455 S MAIN STREET, STE 101, HINESVILLE, GA 31313-4354
(912) 876-6868
(912) 876-6566
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
049871
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00936537A
—
GA
Enumeration date
12/05/2006
Last updated
05/06/2010
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