Organization
LIFE CYCLE OB/GYN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE SIREY SIGOUIN (PRACTICE MANAGER)
(404) 405-4543
Entity
Organization
Contact information
Practice address
428 WINN CT, DECATUR, GA 30030-1726
(404) 766-8371
Mailing address
2739 FELTON DR, EAST POINT, GA 30344-3603
(404) 766-8371
(404) 767-3926
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300035567E
—
GA
Enumeration date
12/11/2017
Last updated
12/11/2017
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