Provider Demographics
NPI:1083422414
Name:FREE TO BE PEDIATRICS, LLC
Entity type:Organization
Organization Name:FREE TO BE PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:KORRELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-220-0324
Mailing Address - Street 1:465 LOCHMOOR PL
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-2053
Mailing Address - Country:US
Mailing Address - Phone:480-220-0324
Mailing Address - Fax:
Practice Address - Street 1:465 LOCHMOOR PL
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-2053
Practice Address - Country:US
Practice Address - Phone:480-220-0324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty