# MT VERNON OB/GYN, LLC

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

## Provider details

- **NPI number:** 1811928054
- **Authorized official:** STEPHEN C BLANK MD (OWNER)
- **Authorized official phone:** (404) 256-2277

## Contact information

- **Practice address:** 755 MOUNT VERNON HWY NE, \#330, ATLANTA, GA 30328-4274
- **Practice address phone:** (404) 256-2277
- **Mailing address:** 3025 BRECKINRIDGE BLVD, SUITE 120, DULUTH, GA 30096-7611
- **Mailing address phone:** (678) 226-0082

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 019640 | GA | Yes |

## Other

- **Enumeration date:** 07/05/2006
- **Last updated:** 12/05/2007