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Contact Information

CHILDREN AND TEENAGERS CLINIC
2401 S. TUCKER AVE.
SUITE 4
PITTSBURG, KS66762
 Phone: 620-231-2490
 Fax: 620-231-3920
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for CHILDREN AND TEENAGERS CLINIC

NPI # 1558492702
LBN Legal business name CHILDREN AND TEENAGERS CLINIC
Authorized official AMY DODSON - (MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/08/2007
Last updated 03/01/2016 - About 10 years ago
Identifiers
KS Medicaid 100270880A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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