Unknown Individual – Pediatrics Physician, NPI 1639153406
Pediatrics Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
410, Newnan Street, Carrollton, Carroll County, Georgia, 30117, United States
CARROLLTON, GA 301173111
Phone: (770) 832-1103
Fax: (770) 832-1142
Type: Location
515, Birkdale Boulevard, Carrollton, Carroll County, Georgia, 30116, United States
CARROLLTON, GA 301169019
Phone: (770) 832-1103
Fax: (770) 832-1142
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30117)
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