Organization
KIDS TIME PEDIATRICS - EAST COBB LLC
Active
Other names
Kids Time Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
FLYNN CLYBURN (MANAGER)
(706) 342-2180
Entity
Organization
Contact information
Practice address
696 BILLUPS AVE, MADISON, GA 30650-1439
(706) 342-2180
Mailing address
3535 ROSWELL RD, SUITE 54, MARIETTA, GA 30062-8826
(404) 943-1979
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
32201
GA
Other
Enumeration date
06/23/2010
Last updated
06/23/2010
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