Organization
DEKALB PEDIATRIC ASSOCIATES PC
Active
Parent organization
DEKALB PEDIATRIC ASSOCIATES PC
Other names
Health care
Organization subpart
Yes
Provider details
NPI number
Legal business name
DEKALB PEDIATRIC ASSOCIATES PC
Authorized official
DR. RONALD A HOMER MD (CEO)
(404) 446-4600
Entity
Organization
Contact information
Practice address
1390 MONTREAL RD STE 180, TUCKER, GA 30084-8187
(404) 446-4600
(404) 446-4601
Mailing address
1390 MONTREAL RD STE 180, TUCKER, GA 30084-8187
(404) 446-4600
(404) 446-4601
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
050105
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000940266K
—
GA
Enumeration date
10/27/2011
Last updated
10/27/2011
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