Organization
PEDIATRIC HEALTH GROUP PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RENNAN MALAZARTE QUIJANO MD (PRESIDENT)
(270) 824-9898
Entity
Organization
Contact information
Practice address
550 HOSPITAL DRIVE, MADISONVILLE, KY 42431-1652
(270) 824-9898
(270) 824-9185
Mailing address
550 HOSPITAL DRIVE, MADISONVILLE, KY 42431-1652
(270) 824-9898
(270) 824-9185
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/13/2007
Last updated
04/28/2008
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