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Contact Information

SOUTHSIDE PEDIATRICS, P.C.
502 BEECH ST
FARMVILLE, VA23901-1222
 Phone: 434-392-9438
 Fax: 434-392-7630
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Legal Medicine

173000000X
Indicates primary specialty

NPI Profile & details for SOUTHSIDE PEDIATRICS, P.C.

NPI # 1366525040
LBN Legal business name SOUTHSIDE PEDIATRICS, P.C.
Authorized official TERESITA DIONISIO - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/24/2006
Last updated 06/09/2022 - About 4 years ago
Identifiers
VA License # 0101035421
VA Medicaid 006702767
VA Medicaid 010018579
VA Other 081150 DR D ANTHEM#
VA Other 99161 OPTIMA # DR D
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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