Provider Demographics
NPI:1548416779
Name:CENTER FOR OB-GYN PLLC
Entity Type:Organization
Organization Name:CENTER FOR OB-GYN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHRISTIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:228-818-0025
Mailing Address - Street 1:PO BOX 4017
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39535
Mailing Address - Country:US
Mailing Address - Phone:228-818-0025
Mailing Address - Fax:228-818-0027
Practice Address - Street 1:2113 GOVERNMENT ST
Practice Address - Street 2:BLDG I
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564
Practice Address - Country:US
Practice Address - Phone:228-818-0025
Practice Address - Fax:228-818-0027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-07
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS16928207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00122660Medicaid
MS160000561Medicare PIN
H01271Medicare UPIN