Provider Demographics
NPI:1710002464
Name:LANIER OBSTETRICS AND GYNECOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:LANIER OBSTETRICS AND GYNECOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-536-0149
Mailing Address - Street 1:1285 SIMS ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-3851
Mailing Address - Country:US
Mailing Address - Phone:770-536-0149
Mailing Address - Fax:770-536-0317
Practice Address - Street 1:1285 SIMS ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3851
Practice Address - Country:US
Practice Address - Phone:770-536-0149
Practice Address - Fax:770-536-0317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty