| NPI | 1902132509 |
|---|---|
| Doing Business As | SISKIN CENTER FOR DEVELOPMENTAL PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | STEPHANIE COOPER-WILKES Director Healthcare Administration 423-490-7727 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2019-10-25 |