Organization
PEDIATRICS TO PARENTS MEDICAL, PC
Active
Other names
Peds to Parents
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD JC FEJERAN DO (PRESIDENT AND PHYSICIAN)
(423) 626-1931
Entity
Organization
Contact information
Practice address
1442 N BROAD ST, SUITE 7, TAZEWELL, TN 37879-4361
(423) 626-1931
Mailing address
PO BOX 959, NEW TAZEWELL, TN 37824-0959
(423) 626-1931
(423) 626-1948
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
000999
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3303563
—
TN
Enumeration date
11/30/2007
Last updated
08/12/2008
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