Organization
SOUTH JACKSON PEDIATRICS, P.C.
Active
Other names
Riverside Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDRA KILIAN M.D. (PRESIDENT)
(517) 780-9260
Entity
Organization
Contact information
Practice address
760 W FRANKLIN ST, JACKSON, MI 49201-2048
(517) 780-9260
(517) 780-9263
Mailing address
760 W FRANKLIN ST, JACKSON, MI 49201-2048
(517) 780-9260
(517) 780-9263
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350C81070
BLUE CROSS BLUE SHIELD
MI
Enumeration date
05/30/2006
Last updated
07/18/2014
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