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Organization

AUGUST PEDIATRICS, LLC

Active
Other names
Neighborhood Pediatrics
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MATTHEW BROCK (CEO & OWNER)
(606) 302-7015
Entity
Organization

Contact information

Practice address
123 N 19TH ST STE 302, MIDDLESBORO, KY 40965
(606) 302-7036
Mailing address
123 N 19TH ST STE 302, MIDDLESBORO, KY 40965-2865
(606) 302-7036

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0123456789
MI
Enumeration date
02/12/2019
Last updated
02/13/2019
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