Organization
HIGHROAD PEDIATRICS, PA
Active
Other names
Kernersville Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT ERIC TOLLEY (PRACTICE ADMINISTRATOR)
(336) 765-9000
Entity
Organization
Contact information
Practice address
815 OLD WINSTON RD, KERNERSVILLE, NC 27284-7121
(336) 996-3001
(336) 996-4687
Mailing address
2808 MAPLEWOOD AVE, WINSTON SALEM, NC 27103-4138
(336) 765-9000
(336) 765-5702
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
36479
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5903823
—
NC
Enumeration date
01/30/2009
Last updated
01/30/2009
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