THE CHILDRENS CLINIC, PLLC. (NPI# 1669523684) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669523684 |
| Entity Type | Organization |
| Organization Name | THE CHILDRENS CLINIC, PLLC. |
| Practice Address |
420 Loretta Road Lebanon KY 40033 |
| Practice Telephone | 2706992210 |
| Practice Fax Number | 2706994335 |
| Mailing Telephone | 2706992210 |
| Mailing Fax Number | 2706994335 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MAX GUCILATAR (OWNER) |
| Authorized Official Telephone | 2706992210 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 39507 | KY | Allopathic & Osteopathic Physicians |
| Street Address |
420 LORETTA ROAD |
| City | LEBANON |
| State | KY |
| Zip Code | 40033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538636311 | One Cross Health Clinic, Inc. | Clinic/Center | 305 Koehler Drive, Lebanon, KY 40033 | 2018-10-30 |
| 1467848952 | Kelly Renee Deatley | Family Medicine | 325 W Walnut St Ste 600, Lebanon, KY 40033 | 2015-04-10 |
| 1003204892 | Mmhh, LLC | Clinic/Center | 135 E. Martin Luther King Ave., Lebanon, KY 40033 | 2014-12-31 |
| 1194964510 | Gregory W. Schall, Do, Pllc | Family Medicine | 312 W High Street, Lebanon, KY 40033 | 2009-02-09 |
| 1780859553 | Wal-mart Stores East, Lp | Eyewear Supplier (Equipment, not the service) | 2136 Campbellsville Road, Lebanon, KY 40033 | 2008-04-23 |
| 1144491234 | William Duley IIi | Dentist | 219 West Main St, Lebanon, KY 40033 | 2008-03-17 |
| 1891965927 | Dana Michelle Logsdon | Nurse Practitioner | 727 W. Main St., Lebanon, KY 40033 | 2008-03-05 |
| 1215022348 | Marion County Anesthesia Associates Pllc | Nurse Anesthetist, Certified Registered | 320 Loretto Road, Lebanon, KY 40033 | 2006-10-04 |
| 1568479426 | Daniel Earl Bailey Jr. | Specialist | 420 Loretto Rd, Suite 600, Lebanon, KY 40033 | 2006-08-02 |
| 1912952458 | Quinton Meek | Psychiatry & Neurology | 65 Old Sprinfield Rd., Lebanon, KY 40033 | 2006-05-23 |
| Find all providers in zip 40033 | ||||
| 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 |
|---|---|---|---|---|
| 1336671064 | Mahoussi Nicole Aholoukpe | Pediatrics | 618 Cornwall Rd Ste 2, Lebanon, PA 17042-7089 | 2017-03-31 |
| 1124318563 | Vernon David Savell Jr. | Pediatrics | 832 Pebble Cove Rd, Lebanon, TN 37087-1004 | 2011-04-19 |
| 1952504250 | Otto Pediatrics | Pediatrics | 1570 Cornwall Road, Lebanon, PA 17042 | 2007-06-06 |
| 1972687309 | Deborah Wen-yee Mark | Pediatrics | 115 Winwood Drive, Centennial Pediatrics Ste 105, Lebanon, TN 37087 | 2006-10-24 |
| 1578586939 | Gene P Otto IIi | Pediatrics | 1570 Cornwall Rd, Lebanon, PA 17042-7403 | 2006-07-26 |
| 1003834441 | Russell County Clinic Corp | Pediatrics | 640 Overlook Drive, Lebanon, VA 24266 | 2006-07-17 |
| 1245276310 | John Fischer | Pediatrics | 1390 Route 22 W, Lebanon, NJ 08833 | 2006-06-20 |
| 1841234168 | Harinder Singh Grewal | Pediatrics | 330 Loretto Rd, Ste 700, Lebanon, KY 40033-1308 | 2006-06-16 |
| 1437105079 | Eric Yorke | Pediatrics | 1390 Us Highway 22, Lebanon, NJ 08833-2217 | 2006-05-25 |
| 1295783843 | Mita Patel | Pediatrics | 1608 N Lebanon St, Lebanon, IN 46052-1514 | 2006-05-05 |
| Find all providers in LEBANON | ||||
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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.