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Organization

LAKESIDE OB/GYN AND PELVIC SURGERY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
REBECCA LYNN MASSEY (PRACTICE ADMINISTRATOR)
(678) 450-4757
Entity
Organization

Contact information

Practice address
1498 JESSE JEWELL PKWY SE, SUITE D, GAINESVILLE, GA 30501-3852
(678) 450-4757
(678) 450-4758
Mailing address
PO BOX 2994, GAINESVILLE, GA 30503-2994
(678) 450-4757
(678) 450-4758

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary

Other

Enumeration date
01/16/2009
Last updated
01/16/2009
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