Organization
PEDIATRIC ASSOCIATES
Active
Other names
Pediatric Associates of Hazard
Organization subpart
No
Provider details
NPI number
Authorized official
DJIEN HWAT SO (ADMINISTRATOR)
(606) 487-8300
Entity
Organization
Contact information
Practice address
1710 N MAIN ST, PEDIATRIC ASSOCIATES, HAZARD, KY 41701-1278
(606) 487-8300
(606) 436-9953
Mailing address
PO BOX 2748, PEDIATRIC ASSOCIATES, PIKEVILLE, KY 41502-2748
(606) 432-3221
(606) 437-0438
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
900138
KY
363LF0000X
Family Nurse Practitioner
3006127
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35001627
—
KY
Enumeration date
05/26/2006
Last updated
03/27/2019
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