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Organization

SPECIALTY GYNECOLOGY PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JACQUELINE CHRISTINE CASTAGNO MD (PHYSICIAN OWNER)
(352) 672-4666
Entity
Organization

Contact information

Practice address
2398 MOUNT VERNON RD, SUITE 150, DUNWOODY, GA 30338-3064
(770) 512-7099
(770) 512-7090
Mailing address
2398 MOUNT VERNON RD, SUITE 150, DUNWOODY, GA 30338-3064
(770) 512-7099
(770) 512-7090

Taxonomy

Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
031498
GA
207VG0400X
Gynecology Physician
Primary
044759
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000772285B
GA
Enumeration date
11/29/2006
Last updated
08/24/2011
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