Organization
OBGYN SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE BLACK (OFFICE MANAGER)
(478) 743-4646
Entity
Organization
Contact information
Practice address
380 HOSPITAL DR, SUITE 100, MACON, GA 31217-8001
(478) 743-4646
(478) 742-5549
Mailing address
380 HOSPITAL DR, SUITE 100, MACON, GA 31217-8001
(478) 743-4646
(478) 742-5549
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300019748A
—
GA
Enumeration date
09/14/2006
Last updated
04/15/2014
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