# OBSTETRICS AND GYNECOLOGY SPECIALISTS PC

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

## Provider details

- **NPI number:** 1427003011
- **Authorized official:** JENIE MARIE GRAHAM (CREDENTIALING)
- **Authorized official phone:** (563) 355-1853

## Contact information

- **Practice address:** 5350 EASTERN AVENUE, DAVENPORT, IA 52807
- **Practice address phone:** (563) 355-1853
- **Practice address fax:** (563) 355-0327
- **Mailing address:** 5350 EASTERN AVENUE, DAVENPORT, IA 52807
- **Mailing address phone:** (563) 355-1853
- **Mailing address fax:** (563) 355-0327

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/23/2006
- **Last updated:** 11/15/2017