National Provider Identifier Database

PREMIER PEDIATRIC GROUP INC
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


Contact Information

PREMIER PEDIATRIC GROUP INC.
5386 COX SMITH ROAD
SUITE A
MASON, OH45040
Phone: 513-770-3466
Fax: 513-770-3467
Website:
Specialty Taxonomy Code
* Specialist 174400000X

* Indicates primary specialty

NPI Profile & details for PREMIER PEDIATRIC GROUP INC.

NPI Number 1093922072
Legal business name
LBN
PREMIER PEDIATRIC GROUP INC.
Authorized official BRADLEY JACKSON - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 05/17/2007
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • OH Medicaid: 2426771
  • OH Other: 7200478 AETNA FOR ELIGABILITY

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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