Provider Demographics
NPI:1326229659
Name:GYNECOLOGY ISSUES
Entity Type:Organization
Organization Name:GYNECOLOGY ISSUES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRONT OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:LINDSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-732-7989
Mailing Address - Street 1:8954 HOSPITAL DR STE 120A
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-2271
Mailing Address - Country:US
Mailing Address - Phone:770-732-7989
Mailing Address - Fax:770-732-2389
Practice Address - Street 1:8954 HOSPITAL DR STE 120A
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-2271
Practice Address - Country:US
Practice Address - Phone:770-732-7989
Practice Address - Fax:770-732-2389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033093207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty