Provider Demographics
NPI:1417254533
Name:WARNER ROBINS OB/GYN LLC
Entity Type:Organization
Organization Name:WARNER ROBINS OB/GYN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE AND BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:HINMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-923-2229
Mailing Address - Street 1:233 N HOUSTON RD
Mailing Address - Street 2:SUITE 143 H
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093-3074
Mailing Address - Country:US
Mailing Address - Phone:478-923-2229
Mailing Address - Fax:888-456-6653
Practice Address - Street 1:233 N HOUSTON RD
Practice Address - Street 2:SUITE 143 H
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-3074
Practice Address - Country:US
Practice Address - Phone:478-923-2229
Practice Address - Fax:888-456-6653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-25
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA35676207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000627305CMedicaid
GA000627305CMedicaid