Provider Demographics
NPI:1851459622
Name:DEKALB GYNECOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:DEKALB GYNECOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:D
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-288-0746
Mailing Address - Street 1:4229 SNAP FINGERWOODS DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30335
Mailing Address - Country:US
Mailing Address - Phone:404-288-0746
Mailing Address - Fax:404-288-0925
Practice Address - Street 1:4229 SNAP FINGERWOODS DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30335
Practice Address - Country:US
Practice Address - Phone:404-288-0746
Practice Address - Fax:404-288-0925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty