Provider Demographics
NPI:1902855877
Name:GOLDSBORO OB-GYN, ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:GOLDSBORO OB-GYN, ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:G
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-735-3464
Mailing Address - Street 1:2608 HOSPITAL ROAD
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-9423
Mailing Address - Country:US
Mailing Address - Phone:919-735-3464
Mailing Address - Fax:919-735-0080
Practice Address - Street 1:2608 HOSPITAL ROAD
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-9423
Practice Address - Country:US
Practice Address - Phone:919-735-3464
Practice Address - Fax:919-735-0080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89011AGMedicaid
NC89011AGMedicaid