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Contact Information

ACTIVE KIDS PEDIATRICS, PC
15215 S 48TH ST
SUITE 110
PHOENIX, AZ85044-9142
 Phone: 480-783-8960
 Fax: 480-783-8967
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Health Service

261QH0100X
Indicates primary specialty

NPI Profile & details for ACTIVE KIDS PEDIATRICS, PC

NPI Number 1629325378
LBN Legal business name ACTIVE KIDS PEDIATRICS, PC
Authorized official JUDITH BARNES CLARK - (PEDIATRICIAN, CO-OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/13/2012
Last updated 08/13/2012 - About 14 years ago
Identifiers
AZ License # A32674
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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