Organization
GEORGETOWN PEDIATRICS, PSC
Active
Other names
Georgetown Pediatrics, PSC
Organization subpart
No
Provider details
NPI number
Authorized official
JOHANNE GOODYKOONTZ (OFFICE MANAGER)
(502) 863-6426
Entity
Organization
Contact information
Practice address
1162 LEXINGTON RD, GEORGETOWN, KY 40324-9330
(502) 863-6426
(502) 868-9724
Mailing address
1162 LEXINGTON RD, GEORGETOWN, KY 40324-9330
(502) 863-6426
(502) 868-9724
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
363LP0200X
Pediatric Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/26/2019
Last updated
04/12/2023
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