OrganizationActive
Kids-Doc-On-Wheels
NPI 1497277404 · Pediatrics Physician · Clarkston, GA
Provider details
- NPI number
- 1497277404
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Lynette Wilson-Phillips, Board of Directors(404) 574-2512
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(74/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4112 E Ponce De Leon Ave # 2
Clarkston, GA 30021-8106
Phone: (404) 574-2512
Fax: (404) 296-7211
Street-level locationGet directions
Mailing address
4112 E Ponce De Leon Ave # 2
Clarkston, GA 30021-8106
Additional practice locations (1)
- 4112 E Ponce De Leon Ave # 2Clarkston, GA 30021-8106Phone: (404) 574-2512Fax: (404) 296-7211
Registry dates
- Enumerated
- 2017-07-11
- Last updated
- 2017-12-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.