Provider Demographics
NPI:1447467931
Name:CHILDRENS OASIS PEDIATRICS
Entity type:Organization
Organization Name:CHILDRENS OASIS PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:KRIEG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-792-1012
Mailing Address - Street 1:1425 W ELLIOT RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-5129
Mailing Address - Country:US
Mailing Address - Phone:480-792-1012
Mailing Address - Fax:480-792-1013
Practice Address - Street 1:1425 W ELLIOT RD
Practice Address - Street 2:SUITE 204
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-5129
Practice Address - Country:US
Practice Address - Phone:480-792-1012
Practice Address - Fax:480-792-1013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty