Organization
GRAYSON PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE A OPEKA CPNP (NP, CFO)
(678) 381-2630
Entity
Organization
Contact information
Practice address
297 COOPER RD, LOGANVILLE, GA 30052-2518
(678) 381-2630
(678) 381-2627
Mailing address
297 COOPER RD, LOGANVILLE, GA 30052-2518
(678) 381-2630
(678) 381-2627
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
057218
GA
363LP0200X
Pediatric Nurse Practitioner
RN154025
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003109575E
—
GA
05
—
003172811A
—
GA
05
—
003172811D
—
GA
05
—
003191294B
—
GA
05
—
003215265A
—
GA
05
—
1831365964
—
GA
05
—
452405206M
—
GA
Enumeration date
05/19/2014
Last updated
10/13/2025
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