# DOURRON WOMEN'S SPECIALIST

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

## Provider details

- **NPI number:** 1629390133
- **Authorized official:** DR. MARIA L DOURRON M.D. (OWNER/PHYSICIAN)
- **Authorized official phone:** (678) 381-1531

## Contact information

- **Practice address:** 253 UPPER RIVERDALE RD SW, SUITE B, RIVERDALE, GA 30274-4945
- **Practice address phone:** (678) 381-1531
- **Practice address fax:** (678) 990-3767
- **Mailing address:** 253 UPPER RIVERDALE RD SW, SUITE B, RIVERDALE, GA 30274-4945
- **Mailing address phone:** (678) 381-1531
- **Mailing address fax:** (678) 990-3767

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 014308 | GA | Yes |
| 207VG0400X | Gynecology Physician | 014308 | GA | — |
| 207VX0000X | Obstetrics Physician | 014308 | GA | — |

## Other

- **Enumeration date:** 02/25/2010
- **Last updated:** 12/11/2010