Healthcare Provider Details

I. General information

NPI: 1518512953
Provider Name (Legal Business Name): BUCKHEAD UROGYNECOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2019
Last Update Date: 08/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 PEACHTREE RD NE STE 670
ATLANTA GA
30309-1632
US

IV. Provider business mailing address

2815 W ROXBORO RD NE
ATLANTA GA
30324-2916
US

V. Phone/Fax

Practice location:
  • Phone: 267-970-4550
  • Fax:
Mailing address:
  • Phone: 267-970-4550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOYE LOWMAN
Title or Position: OWNER
Credential: MD, MPH
Phone: 267-970-4550