Organization
HENRY COUNTY PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISHRAT ARA HUSSAIN MD (OWNER/MD)
(770) 474-6969
Entity
Organization
Contact information
Practice address
125 EAGLES POINTE PKWY, SUITE 120, STOCKBRIDGE, GA 30281-6379
(770) 474-6969
(770) 474-6996
Mailing address
125 EAGLES POINTE PKWY, SUITE 120, STOCKBRIDGE, GA 30281-6379
(770) 474-6969
(770) 474-6996
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000892746D
—
GA
01
—
1851474795
PROVIDER NPI
GA
Enumeration date
09/24/2010
Last updated
09/24/2010
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