Provider Demographics
NPI:1154446284
Name:GEORGIA REPRODUCTIVE SPECIALISTS, LLC
Entity Type:Organization
Organization Name:GEORGIA REPRODUCTIVE SPECIALISTS, LLC
Other - Org Name:SGF ATLANTA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:GERBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-545-1248
Mailing Address - Street 1:9600 BLACKWELL ROAD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850
Mailing Address - Country:US
Mailing Address - Phone:301-340-1188
Mailing Address - Fax:855-716-1603
Practice Address - Street 1:1100 LAKE HEARN DR STE 400
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1524
Practice Address - Country:US
Practice Address - Phone:404-843-2229
Practice Address - Fax:404-843-0812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty