Organization
PEDIATRIC PARTNERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE L. EUBANKS (ADMINISTRATOR)
(706) 548-1216
Entity
Organization
Contact information
Practice address
1520B JENNINGS MILL RD, BOGART, GA 30622-2543
(706) 548-1216
(706) 548-1772
Mailing address
1520B JENNINGS MILL RD, BOGART, GA 30622-2543
(706) 548-1216
(706) 548-1772
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85002970G
—
GA
Enumeration date
10/11/2005
Last updated
08/22/2020
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