Organization
PROVIDENCE OBGYN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURI BULLEN MD (SOLE PARTNER)
(843) 614-9917
Entity
Organization
Contact information
Practice address
206 FAIRVIEW PARK DR, DUBLIN, GA 31021-2547
(478) 246-4304
(478) 246-4282
Mailing address
206 FAIRVIEW PARK DR, DUBLIN, GA 31021-2547
(478) 246-4304
(478) 246-4282
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
06/27/2022
Last updated
11/17/2025
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