Provider Demographics
NPI:1932776424
Name:ALPHA OMEGA OB GYN
Entity Type:Organization
Organization Name:ALPHA OMEGA OB GYN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:P
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-883-3032
Mailing Address - Street 1:3400 OLD MILTON PKWY
Mailing Address - Street 2:BLG C., STE. 475B
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005
Mailing Address - Country:US
Mailing Address - Phone:470-554-7870
Mailing Address - Fax:470-554-7872
Practice Address - Street 1:3400 OLD MILTON PKWY
Practice Address - Street 2:BLG C., STE. 475B
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005
Practice Address - Country:US
Practice Address - Phone:470-554-7870
Practice Address - Fax:470-554-7872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty