Provider Demographics
NPI:1306973151
Name:GA KIDZ PEDIATRICS. P.C.
Entity type:Organization
Organization Name:GA KIDZ PEDIATRICS. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEZLIE
Authorized Official - Middle Name:F
Authorized Official - Last Name:BILES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-775-4540
Mailing Address - Street 1:146 SYLVAN DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:GA
Mailing Address - Zip Code:30233-1548
Mailing Address - Country:US
Mailing Address - Phone:770-775-4540
Mailing Address - Fax:770-775-4078
Practice Address - Street 1:146 SYLVAN DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:GA
Practice Address - Zip Code:30233-1548
Practice Address - Country:US
Practice Address - Phone:770-775-4540
Practice Address - Fax:770-775-4078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1033267364OtherNPI
GA1063563468OtherNPI