Provider Demographics
NPI:1679797161
Name:DOUGLAS PEDIATRICS ASSOCIATES INC. P.C.
Entity type:Organization
Organization Name:DOUGLAS PEDIATRICS ASSOCIATES INC. P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARKINS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:770-949-2250
Mailing Address - Street 1:9280 HIGHWAY 5
Mailing Address - Street 2:SUITE A
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-1501
Mailing Address - Country:US
Mailing Address - Phone:770-949-2250
Mailing Address - Fax:770-489-4593
Practice Address - Street 1:9280 HIGHWAY 5
Practice Address - Street 2:SUITE A
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-1501
Practice Address - Country:US
Practice Address - Phone:770-949-2250
Practice Address - Fax:770-489-4593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty