Provider Demographics
NPI:1194996249
Name:PEDIATRIC CONSULTANTS, INC
Entity type:Organization
Organization Name:PEDIATRIC CONSULTANTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:WIMBERLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-582-3100
Mailing Address - Street 1:1930 ALCOA HWY
Mailing Address - Street 2:STE 145
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1500
Mailing Address - Country:US
Mailing Address - Phone:865-582-3100
Mailing Address - Fax:865-544-6572
Practice Address - Street 1:1930 ALCOA HWY
Practice Address - Street 2:STE 145
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1500
Practice Address - Country:US
Practice Address - Phone:865-582-3100
Practice Address - Fax:865-544-6572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty