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Contact Information

PEDIATRIC SPECIALISTS LLC
505 KLUTEY PARK PLAZA DR
HENDERSON, KY42420-5224
 Phone: 270-830-0313
 Fax: 270-830-7117
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Gastroenterology

2080P0206X 37 Physician/Pediatric Medicine
 

Neonatal-Perinatal Medicine

2080N0001X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for PEDIATRIC SPECIALISTS LLC · (Female)

NPI Number 1184789364
Status Active
Credentials
Entity Individual
Enumeration date 12/27/2006
Last updated 09/11/2025 - About 9 months ago
Sole proprietor 1 Not specified
Identifiers
  • KY License # 27410
  • KY License # 27411
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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