Organization
IDEAL GYNECOLOGY 2, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY DEPP (PAYER RELATIONS LIAISON)
(770) 579-2626
Entity
Organization
Contact information
Practice address
3200 DOWNWOOD CIR NW STE 220, ATLANTA, GA 30327-1611
(470) 312-3696
(866) 278-2622
Mailing address
PO BOX 468329, ATLANTA, GA 31146-8329
(404) 943-0205
(404) 943-0209
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
40540
GA
Other
Enumeration date
05/22/2017
Last updated
05/22/2017
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