Provider Demographics
NPI:1548603376
Name:PREMIER OB/GYN, LLC
Entity Type:Organization
Organization Name:PREMIER OB/GYN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NJIDEKA
Authorized Official - Middle Name:CHINYELU
Authorized Official - Last Name:OBIEKWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-705-2900
Mailing Address - Street 1:2505 VILLAGE PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-2381
Mailing Address - Country:US
Mailing Address - Phone:334-705-2900
Mailing Address - Fax:334-705-2909
Practice Address - Street 1:2412 VILLAGE PROFESSIONAL DRIVE S.
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-2909
Practice Address - Country:US
Practice Address - Phone:334-705-2900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-11
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty