Healthcare Provider Details

I. General information

NPI: 1912045345
Provider Name (Legal Business Name): OBSTETRICAL AND GYNECOLOGICAL ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 09/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 EAST US HIGHWAY 6 SUITE 330
VALPARAISO IN
46383
US

IV. Provider business mailing address

85 EAST US HIGHWAY 6 SUITE 330
VALPARAISO IN
46383
US

V. Phone/Fax

Practice location:
  • Phone: 219-462-6144
  • Fax: 219-465-1150
Mailing address:
  • Phone: 219-462-6144
  • Fax: 219-465-1150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: CRYSTAL A STRICKLAND
Title or Position: PRESIDENT, PHYSICIAN
Credential: MD FACOG
Phone: 219-462-6144