Healthcare Provider Details

I. General information

NPI: 1780715219
Provider Name (Legal Business Name): GYN RESOURCES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 08/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

987 CHATTAHOOCHEE AVE NW SUITE A
ATLANTA GA
30318-3701
US

IV. Provider business mailing address

987 CHATTAHOOCHEE AVE NW SUITE A
ATLANTA GA
30318-3701
US

V. Phone/Fax

Practice location:
  • Phone: 404-605-7177
  • Fax:
Mailing address:
  • Phone: 404-605-7177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TERRY TEMPLEMAN
Title or Position: OWNER
Credential:
Phone: 404-605-7177