Organization
PEACHTREE PEDIATRICS, PLLC
Active
Other names
Peachtree Pediatric Clinic, P.A.
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN GIBSON WAGGONER D.O. (OWNER)
(828) 837-2128
Entity
Organization
Contact information
Practice address
125 MEDICAL PARK LN, SUITE F, MURPHY, NC 28906-6920
(828) 837-2128
(828) 837-6244
Mailing address
125 MEDICAL PARK LN, SUITE F, MURPHY, NC 28906-6920
(828) 837-2128
(828) 837-6244
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89012C7
—
NC
Enumeration date
02/28/2007
Last updated
09/12/2016
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