Healthcare Provider Details

I. General information

NPI: 1689772584
Provider Name (Legal Business Name): NORTH GEORGIA WOMEN'S CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 01/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 CHATTANOOGA RD
DALTON GA
30720-8379
US

IV. Provider business mailing address

1525 CHATTANOOGA RD
DALTON GA
30720-8379
US

V. Phone/Fax

Practice location:
  • Phone: 706-226-3373
  • Fax: 706-226-0845
Mailing address:
  • Phone: 706-226-3373
  • Fax: 706-226-0845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANTHONY RAY HARBIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 706-226-3373