Provider Demographics
NPI:1699233890
Name:IN & OUT PEDICATRICS
Entity type:Organization
Organization Name:IN & OUT PEDICATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEARD
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:334-275-7658
Mailing Address - Street 1:2135 INTERSTATE DR STE 197
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-1526
Mailing Address - Country:US
Mailing Address - Phone:334-275-7658
Mailing Address - Fax:531-200-7534
Practice Address - Street 1:1995 PEPPERELL PKWY STE 6
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5460
Practice Address - Country:US
Practice Address - Phone:334-275-7658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-06
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care