National Provider Identifier Database

COVENANT PEDIATRICS PLLC
Rural Health


Contact Information

COVENANT PEDIATRICS, PLLC
421 OLD RICEVILLE RD STE 2
ATHENS, TN37303-3074
Phone: 423-744-8755
Fax: 423-744-8568
Website:
Specialty Taxonomy Code
* Rural Health 261QR1300X

* Indicates primary specialty

NPI Profile & details for COVENANT PEDIATRICS, PLLC

NPI Number 1659670412
Legal business name
LBN
COVENANT PEDIATRICS, PLLC
Authorized official OMER BREEDEN - (BUSINESS MANAGER)
Entity Organization
Organization subpart No
Enumeration date 03/19/2011
Last updated 05/23/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers
  • TN License #: MD19704

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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