Organization
KIDS TIME PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FLYNN CLYBURN (PRESIDENT)
(706) 342-2180
Entity
Organization
Contact information
Practice address
696 BILLUPS AVE, MADISON, GA 30650-1439
(706) 342-2180
Mailing address
696 BILLUPS AVE, MADISON, GA 30650-1439
(706) 342-2180
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
06/22/2007
Last updated
06/18/2008
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