Provider Demographics
NPI:1609916337
Name:DUBLIN OB-GYN & ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:DUBLIN OB-GYN & ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:P
Authorized Official - Last Name:SIMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-272-8580
Mailing Address - Street 1:23 ERIN OFFICE PARK
Mailing Address - Street 2:2400 BELLEVUE ROAD
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-2866
Mailing Address - Country:US
Mailing Address - Phone:478-272-8580
Mailing Address - Fax:478-275-0012
Practice Address - Street 1:23 ERIN OFFICE PARK
Practice Address - Street 2:2400 BELLEVUE ROAD
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-2866
Practice Address - Country:US
Practice Address - Phone:478-272-8580
Practice Address - Fax:478-275-0012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA017442174400000X
GA052127174400000X
GA017714174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00083531DMedicaid
GA00082233AMedicaid
GA224745520AMedicaid
GA16BDDKGMedicare ID - Type Unspecified
GA00083531DMedicaid
GA00082233AMedicaid