Provider Demographics
NPI:1811227317
Name:ATLANTIC COAST GYNECOLOGY INC.
Entity Type:Organization
Organization Name:ATLANTIC COAST GYNECOLOGY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CINAR
Authorized Official - Middle Name:A H
Authorized Official - Last Name:AKSU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-414-4082
Mailing Address - Street 1:PO BOX 2877
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-2877
Mailing Address - Country:US
Mailing Address - Phone:706-414-4082
Mailing Address - Fax:
Practice Address - Street 1:100 TIMBER TRAIL RD STE 101
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-9416
Practice Address - Country:US
Practice Address - Phone:706-414-4082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056401261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1700974284OtherNPI FOR THE OWNER/MD
1700974284OtherNPI FOR THE OWNER/MD
16BBDBPMedicare PIN