Provider Demographics
NPI:1538215280
Name:PARTNERS IN PEDIATRICS, P.C.
Entity type:Organization
Organization Name:PARTNERS IN PEDIATRICS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-377-7100
Mailing Address - Street 1:7110 FOREST AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3786
Mailing Address - Country:US
Mailing Address - Phone:804-377-7100
Mailing Address - Fax:804-377-8511
Practice Address - Street 1:7110 FOREST AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3786
Practice Address - Country:US
Practice Address - Phone:804-377-7100
Practice Address - Fax:804-377-8511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208000000X
VA010149312208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty