Organization Name: | LOWCOUNTRY PEDIATRICS |
NPI Number: | 1164531349 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ZOE KLECKNER POGUE (PRESIDENT/DOCTOR) |
Mailing Address: | 101 Springhall Dr Goose Creek |
State: | SC US |
Postal Code: | 294455336 |
Phone Number: | 8435723300 |
Fax Number: | 8437973331 |
NPI Enumeration Date: | 08/30/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 1994738 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | 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. |