Organization
THOMASTON PEDIATRICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN L DELLI-GATTI M.D. (DOCTOR)
(706) 647-1680
Entity
Organization
Contact information
Practice address
403 W GORDON ST, THOMASTON, GA 30286-3423
(706) 647-1680
(706) 646-3125
Mailing address
403 W GORDON ST, THOMASTON, GA 30286-3423
(706) 647-1680
(706) 646-3125
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003048078A
PEACH STATE HEALTH PLAN
GA
05
—
000304807A
—
GA
01
—
319469
WELLCARE OF GEORGIA
GA
Enumeration date
08/05/2008
Last updated
08/05/2008
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