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Organization

PEDIATRIC CARE AFTER HOURS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIMBERLY T. BLEVENS MD (PHYSICIAN)
(478) 923-0131
Entity
Organization

Contact information

Practice address
116 S HOUSTON RD, WARNER ROBINS, GA 31088-3904
(478) 923-0131
(478) 922-6530
Mailing address
116 S HOUSTON RD, WARNER ROBINS, GA 31088-3904
(478) 923-0131
(478) 922-6530

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
032131
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000400419B
GA
Enumeration date
01/31/2008
Last updated
04/13/2009
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