NPI age
20 years
Enumerated 2005-10-06
Across 1893 active obstetrics & gynecology providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 149091402 | |
| 01 (GA) | 207V00000X | TAXONOMY |
| 01 (GA) | 073667 | STATE LICENSE |
| 01 (GA) | 1487642278 | NPI |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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