Organization
LOUDON PEDIATRIC CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES PERRY GUIDER M.D. (PRESIDENT)
(865) 458-5666
Entity
Organization
Contact information
Practice address
616 WARD AVE, LOUDON, TN 37774-1323
(865) 458-5666
(865) 458-9906
Mailing address
616 WARD AVE, LOUDON, TN 37774-1323
(865) 458-5666
(865) 458-9906
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
12939
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1503978
—
TN
Enumeration date
05/20/2008
Last updated
03/07/2014
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