Organization
GLENS FALLS OBSTETRICS & GYNECOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS PROVOST MD (PHYSICIAN)
(518) 798-6165
Entity
Organization
Contact information
Practice address
28 S WESTERN AVE, QUEENSBURY, NY 12804-3323
(518) 798-6165
(518) 798-0658
Mailing address
28 SO WESTERN AVENUE, QUEENSBURY, NY 12804
(518) 798-6165
(518) 798-0658
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
09/05/2006
Last updated
06/02/2015
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