# OB GYN SPECIALISTS OF VIDALIA PC

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

## Provider details

- **NPI number:** 1619965738
- **Authorized official:** INGRID BROWN MD (OWNER)
- **Authorized official phone:** (912) 537-2798

## Contact information

- **Practice address:** 1616 MEADOWS LN, VIDALIA, GA 30474-8914
- **Practice address phone:** (912) 537-2798
- **Practice address fax:** (912) 537-3651
- **Mailing address:** PO BOX 1143, 1616 MEADOWS LANE, VIDALIA, GA 30475-1143
- **Mailing address phone:** (912) 537-2798
- **Mailing address fax:** (912) 537-3651

## Taxonomy

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

## Other

- **Enumeration date:** 10/12/2005
- **Last updated:** 08/22/2020