Organization
DAFFODIL PEDIATRICS AND FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON FREDERICK STACHELRODT (CEO)
(310) 429-8614
Entity
Organization
Contact information
Practice address
4905 COURTNEY DRIVE, FOREST PARK, GA 30297
(404) 366-3636
(404) 362-0808
Mailing address
4905 COURTNEY DRIVE, FOREST PARK, GA 30297
(404) 366-3636
(404) 362-0808
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
02/02/2012
Last updated
09/16/2013
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