Amory Pediatric

Pediatrics Physician · Amory, MS

Organization Active NPI

NPI number 1902020639

Practice location

1107 Earl Frye Blvd Ste 5
Amory, MS 38821-5519
Phone
(662) 257-6705

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NPI record

NPI
1902020639
Entity type
Organization (Type 2)
Enumeration date
April 12, 2007
Last updated
August 22, 2020
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Pediatrics Physician Primary 208000000X — —

Mailing address

123 Main St N
Amory, MS 38821-3416

Authorized official

Name
Chris Dedeaux
Title
Clinic Administrator
Phone
(662) 256-7112

About Amory Pediatric

Amory Pediatric is a healthcare organization registered in the NPI registry with the primary taxonomy Pediatrics Physician (code 208000000X). The practice location is 1107 Earl Frye Blvd Ste 5, Amory, MS 38821-5519. The NPI number 1902020639 was assigned on April 12, 2007 and the record was last updated on August 22, 2020.

The authorized official for this organization is Chris Dedeaux, Clinic Administrator.

Frequently asked questions

What is the NPI number of Amory Pediatric?

The NPI number is 1902020639.

What is the phone number of Amory Pediatric?

The phone number listed for the practice location is (662) 257-6705.

Where is Amory Pediatric located?

1107 Earl Frye Blvd Ste 5, Amory, MS 38821-5519.

What is the taxonomy code for Amory Pediatric?

The primary taxonomy code is 208000000X – Pediatrics Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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