# ELITE OBSTETRICS AND GYNECOLOGY LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1538915210
- **Authorized official:** TRACY GIBBS (MANAGING DIRECTOR)
- **Authorized official phone:** (636) 751-5598

## Contact information

- **Practice address:** 225 PHYSICIANS PARK STE 305, POPLAR BLUFF, MO 63901-3935
- **Practice address phone:** (573) 772-4340
- **Mailing address:** PO BOX 334, VAN BUREN, MO 63965-0334

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 261Q00000X | Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 04/24/2024
- **Last updated:** 05/06/2024