Provider Demographics
NPI:1841361664
Name:PEDIATRIC & ADOLESCENT MEDICINE, L. L. P.
Entity type:Organization
Organization Name:PEDIATRIC & ADOLESCENT MEDICINE, L. L. P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:HEYWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-358-2361
Mailing Address - Street 1:3603 GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-2201
Mailing Address - Country:US
Mailing Address - Phone:804-358-2361
Mailing Address - Fax:804-359-0949
Practice Address - Street 1:3603 GROVE AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23221-2201
Practice Address - Country:US
Practice Address - Phone:804-358-2361
Practice Address - Fax:804-359-0949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty