Provider Demographics
NPI:1700437266
Name:OBSTETRICS AND GYNECOLOGY SOUTH, INC
Entity Type:Organization
Organization Name:OBSTETRICS AND GYNECOLOGY SOUTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-296-0167
Mailing Address - Street 1:3533 SOUTHERN BLVD STE 4600
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-1273
Mailing Address - Country:US
Mailing Address - Phone:937-296-0167
Mailing Address - Fax:
Practice Address - Street 1:700 S STANFIELD RD STE B
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-2569
Practice Address - Country:US
Practice Address - Phone:937-296-0167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OBSTETRICS AND GYNECOLOGY SOUTH, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty