Provider Demographics
NPI:1457598468
Name:GYN & OB OF DEKALB, P.C.
Entity type:Organization
Organization Name:GYN & OB OF DEKALB, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:LANE
Authorized Official - Last Name:HUTCHINSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:404-564-2515
Mailing Address - Street 1:2801 N DECATUR RD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-5949
Mailing Address - Country:US
Mailing Address - Phone:404-299-9307
Mailing Address - Fax:404-299-9309
Practice Address - Street 1:2801 N DECATUR RD
Practice Address - Street 2:SUITE 190
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-5949
Practice Address - Country:US
Practice Address - Phone:404-299-9307
Practice Address - Fax:404-299-9309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-13
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty