Organization
PEDIATRIC ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT M. LICATA MD (PRESIDENT)
(770) 993-2922
Entity
Organization
Contact information
Practice address
3000 JOHNSON FERRY RD, SUITE 204, MARIETTA, GA 30062-5683
(770) 993-2922
(770) 993-7325
Mailing address
3000 JOHNSON FERRY RD, SUITE 204, MARIETTA, GA 30062-5683
(770) 993-2922
(770) 993-7325
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
025457
GA
Other
Enumeration date
05/21/2007
Last updated
08/22/2020
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