Provider Demographics
NPI:1427214642
Name:TEENS, LITTLE ONES AND CHILDREN PEDIATRICS LLC
Entity type:Organization
Organization Name:TEENS, LITTLE ONES AND CHILDREN PEDIATRICS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESTER
Authorized Official - Middle Name:A
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-691-4321
Mailing Address - Street 1:3915 CASCADE RD SW
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-8519
Mailing Address - Country:US
Mailing Address - Phone:404-691-4321
Mailing Address - Fax:404-691-4304
Practice Address - Street 1:3915 CASCADE RD SW
Practice Address - Street 2:SUITE 105
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-8519
Practice Address - Country:US
Practice Address - Phone:404-691-4321
Practice Address - Fax:404-691-4304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-07
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA85002281GMedicaid