Provider Demographics
NPI:1336541374
Name:UNITED OBSTETRICS & GYNECOLOGY
Entity Type:Organization
Organization Name:UNITED OBSTETRICS & GYNECOLOGY
Other - Org Name:SOUTH GEORGIA PHYSICIANS FOR WOMEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-391-3500
Mailing Address - Street 1:PO BOX 1189
Mailing Address - Street 2:
Mailing Address - City:TIFTON
Mailing Address - State:GA
Mailing Address - Zip Code:31793-1189
Mailing Address - Country:US
Mailing Address - Phone:229-382-8822
Mailing Address - Fax:
Practice Address - Street 1:780 26TH AVE SE
Practice Address - Street 2:
Practice Address - City:MOULTRIE
Practice Address - State:GA
Practice Address - Zip Code:31768-6799
Practice Address - Country:US
Practice Address - Phone:229-890-2273
Practice Address - Fax:229-896-8886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-22
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty