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Organization
EAGLES LANDING OB GYN ASSOCIATES, PC
Active
Organization
EAGLES LANDING OB GYN ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE LIVINGSTON (OFFICE MANAGER)
(770) 474-1919
Entity
Organization
Contact information
Practice address
3333 JODECO RD STE D, MCDONOUGH, GA 30253-5319
(404) 455-0110
(770) 474-7832
Mailing address
3333 JODECO RD STE D, MCDONOUGH, GA 30253-5319
(770) 474-1919
(770) 474-7832
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
032893
GA
207V00000X
Obstetrics & Gynecology Physician
036810
GA
207V00000X
Obstetrics & Gynecology Physician
042399
GA
207V00000X
Obstetrics & Gynecology Physician
043639
GA
207V00000X
Obstetrics & Gynecology Physician
046612
GA
207V00000X
Obstetrics & Gynecology Physician
056295
GA
207V00000X
Obstetrics & Gynecology Physician
057739
GA
207V00000X
Obstetrics & Gynecology Physician
65352
GA
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
363LW0102X
Women's Health Nurse Practitioner
RN070819 NP
GA
367A00000X
Advanced Practice Midwife
RN119659
GA
Other
Enumeration date
05/22/2006
Last updated
01/31/2024
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