Provider Demographics
NPI:1326403197
Name:GENERATIONS OBGYN LLC
Entity Type:Organization
Organization Name:GENERATIONS OBGYN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:F
Authorized Official - Last Name:EVITT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-217-9898
Mailing Address - Street 1:610 AIRPORT RD SW
Mailing Address - Street 2:SUITE 210
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-4304
Mailing Address - Country:US
Mailing Address - Phone:256-217-9898
Mailing Address - Fax:
Practice Address - Street 1:610 AIRPORT RD SW
Practice Address - Street 2:SUITE 210
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-4304
Practice Address - Country:US
Practice Address - Phone:256-217-9898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-22
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL33640207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1511274Medicaid
TN103I161259Medicare UPIN
TN1511274Medicaid