TEQUILLA L PRYOR (NPI# 1568807741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568807741 |
| Entity Type | Individual |
| Full Name | TEQUILLA L PRYOR |
| Other Name | TEQUILLA L HUNTER |
| Credential | M.D. |
| Practice Address |
101 Yorktown Dr Ste 201 Fayetteville GA 30214-1501 |
| Practice Telephone | 7704604281 |
| Practice Fax Number | 7704604002 |
| Mailing Telephone | 7704604281 |
| Mailing Fax Number | 7704604002 |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2018-10-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 80923 | GA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 0101260570 | VA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4868 Bridge Rd, Suffolk, VA 234352048 | 7574837115 | 7574837151 |
| Street Address |
101 YORKTOWN DR STE 201 |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-1501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144647090 | Waits Hearing Center, LLC | Audiologist | 101 Yorktown Dr Ste 201, Fayetteville, GA 30214-1501 | 2014-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1962876128 | Melissa Jadick | Pediatrics | 135 Trotters Rdg, Fayetteville, GA 30215-6540 | 2015-11-25 |
| 1891065504 | Camp Creek Pediatrics | Pediatrics | 495 Virginia Highlands, Fayetteville, GA 30215-8233 | 2012-01-11 |
| 1144508698 | Sunshine Pediatrics | Pediatrics | 514 Owen Drive, Fayetteville, NC 28304 | 2011-08-02 |
| 1922339142 | Lynn Covey Morrison | Pediatrics | 460 N Canvas Rd, Fayetteville, AR 72701-4737 | 2010-01-28 |
| 1861627226 | Kidzcare Pediatrics, PC | Pediatrics | 5617 Ramsey Street, Fayetteville, NC 28311-1423 | 2009-05-28 |
| 1053553495 | Neil A Tracy | Pediatrics | 3215 N. North Hill Road, Fayetteville, AR 72703-4424 | 2009-03-31 |
| 1932353208 | Children's Health of Carolina Dba Cumberland Children's Clinic | Pediatrics | 1738 Owen Dr Ste 107, Fayetteville, NC 28304-3419 | 2008-11-12 |
| 1588814628 | Zakiya S Karim | Pediatrics | 1327 Robeson Street, Fayetteville, NC 28305 | 2008-09-25 |
| 1043497985 | Brittany Wilson | Pediatrics | 719 Lanier Ave W, Fayetteville, GA 30214-7634 | 2008-01-22 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.