Organization
KINSTON PEDIATRIC ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD M RIDDLE MD (MD/PRESIDENT)
(252) 522-0335
Entity
Organization
Contact information
Practice address
2509 NORTH QUEEN ST, KINSTON, NC 28502
(252) 522-0335
(252) 522-4016
Mailing address
PO BOX 1419, KINSTON, NC 28503
(252) 522-0335
(252) 522-4016
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8901980
—
NC
01
—
O1980
BLUE CROSS BLUE SHIELD
—
Enumeration date
11/30/2005
Last updated
02/22/2024
Update your record
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