KIDS CHOICE PEDIATRICSLLC NPI 1750509634

NPI Information

NPI: 1750509634
Provider Name: KIDS CHOICE PEDIATRICS,LLC

Doing Business As: VENKATESWARA RAO DIKKALA, M.D.

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
2775 CRUSE RD
SUITE 1801
LAWRENCEVILLE, GA
ZIP 30044
Phone: (678) 380-9199
Get Directions

KIDS CHOICE PEDIATRICS,LLC is a primary care clinic center in Lawrenceville, GA. KIDS CHOICE PEDIATRICS,LLC NPI is 1750509634. The provider is registered as an organization entity type.
The provider Is Doing Business As Venkateswara Rao Dikkala, M.d..

The provider's business location address is:

2775 CRUSE RD
SUITE 1801
LAWRENCEVILLE, GA
ZIP 30044-140
Phone: (678) 380-9199
Fax: (770) 935-0199

The provider's authorized official is Venkateswara Rao Dikkala .
The authorized official title is Member and has the following contact phone number (678) 380-9199.

The CLIA number assigned to this NPI record is 11D1055197 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/23/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	048226	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1023076387	OTHER	GEORGIA	INDIVIDUAL NPI NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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