Organization
PEDIATRICS AT WHITLOCK P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAWRENCE VINCENT POOLD (OFFICE MANAGER)
(770) 499-8909
Entity
Organization
Contact information
Practice address
611 CAMPBELL HILL ST NW STE 103, MARIETTA, GA 30060-1386
(770) 499-8909
(770) 499-8911
Mailing address
611 CAMPBELL HILL ST NW STE 103, MARIETTA, GA 30060-1386
(770) 499-8909
(770) 499-8911
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
047011
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000949044D
—
GA
01
—
1003983693
DR. STEPHANIE L. POOLE'S NPI
GA
Enumeration date
05/15/2008
Last updated
07/07/2014
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