Organization
LILY OBSTETRICS AND GYNECOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TINA F MITCHELL MD (OWNER/PRESIDENT)
(912) 638-1801
Entity
Organization
Contact information
Practice address
7000 WELLNESS WAY, SUITE 7220, ST SIMONS ISLAND, GA 31522-2286
(912) 638-1801
(912) 638-1821
Mailing address
7000 WELLNESS WAY, SUITE 7220, ST SIMONS ISLAND, GA 31522-2286
(912) 638-1801
(912) 638-1821
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
050041
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003118614A
—
GA
Enumeration date
07/05/2011
Last updated
04/09/2012
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