Provider Demographics
NPI:1417986621
Name:GYNECOLOGY ASSOCIATES OF NORTH GEORGIA, LLC
Entity Type:Organization
Organization Name:GYNECOLOGY ASSOCIATES OF NORTH GEORGIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:DELAHANTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-887-0559
Mailing Address - Street 1:2450 ATLANTA HWY,
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040
Mailing Address - Country:US
Mailing Address - Phone:770-887-0559
Mailing Address - Fax:770-887-0338
Practice Address - Street 1:2450 ATLANTA HWY,
Practice Address - Street 2:SUITE 103
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040
Practice Address - Country:US
Practice Address - Phone:770-887-0559
Practice Address - Fax:770-887-0338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty