# IDEAL GYNECOLOGY 2, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003343963
- **Authorized official:** SHELLEY DEPP (PAYER RELATIONS LIAISON)
- **Authorized official phone:** (770) 579-2626

## Contact information

- **Practice address:** 3200 DOWNWOOD CIR NW STE 220, ATLANTA, GA 30327-1611
- **Practice address phone:** (470) 312-3696
- **Practice address fax:** (866) 278-2622
- **Mailing address:** PO BOX 468329, ATLANTA, GA 31146-8329
- **Mailing address phone:** (404) 943-0205
- **Mailing address fax:** (404) 943-0209

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 40540 | GA | Yes |

## Other

- **Enumeration date:** 05/22/2017
- **Last updated:** 05/22/2017