Provider Demographics
NPI:1083855266
Name:ST FRANCIS OBSTETRIC AND GYNECOLOGY, LLC
Entity Type:Organization
Organization Name:ST FRANCIS OBSTETRIC AND GYNECOLOGY, LLC
Other - Org Name:OBGYN ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO, SR VP
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:S
Authorized Official - Last Name:HEMBREE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-596-4000
Mailing Address - Street 1:PO BOX 9027
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31908-9027
Mailing Address - Country:US
Mailing Address - Phone:706-324-4891
Mailing Address - Fax:706-576-4958
Practice Address - Street 1:2300 MANCHESTER EXPY
Practice Address - Street 2:STE B001
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-6808
Practice Address - Country:US
Practice Address - Phone:706-324-4891
Practice Address - Fax:706-576-4958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-17
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202G709629OtherMEDICARE PTAN