Organization
THE CENTER FOR PEDIATRIC EXCELLENCE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK KEITH JOHNSON MD (CEO)
(615) 785-9303
Entity
Organization
Contact information
Practice address
300 STONECREST BLVD STE 250, SMYRNA, TN 37167-6832
(629) 220-0211
(629) 220-0210
Mailing address
300 STONECREST BLVD STE 250, SMYRNA, TN 37167-6832
(629) 220-0211
(629) 220-0210
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
05/22/2022
Last updated
11/30/2023
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