Provider Demographics
NPI:1689810475
Name:ATLANTA SOUTH GYNECOLOGY AND OBSTETRICS P.C.
Entity Type:Organization
Organization Name:ATLANTA SOUTH GYNECOLOGY AND OBSTETRICS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:ARMOND
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-716-5977
Mailing Address - Street 1:500 W LANIER AVE
Mailing Address - Street 2:STE.405
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-7636
Mailing Address - Country:US
Mailing Address - Phone:770-716-5977
Mailing Address - Fax:770-716-5261
Practice Address - Street 1:500 LANIER AVE W STE 407
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7638
Practice Address - Country:US
Practice Address - Phone:770-716-5977
Practice Address - Fax:678-817-5339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-29
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA022635261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD41075Medicare UPIN