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General NPI Number Information
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NPI Number | 1326229659
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Entity Type | Organization
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Legal Business Name | GYNECOLOGY ISSUES
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 11/15/2007
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Provider Practice Location Address
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Address Line | 8954 HOSPITAL DR STE 120A
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-2271
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Country | US
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Telephone | 770-732-7989
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Fax | 770-732-2389
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Provider Business Mailing Address
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Address Line | 8954 HOSPITAL DR STE 120A
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-2271
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Country | US
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Telephone | 770-732-7989
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Fax | 770-732-2389
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Authorized Official
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Title or Position | FRONT OFFICE
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Name | KIMBERLY DIANE LINDSEY
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Credential |
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Telephone | 770-732-7989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 033093
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License Number State | GA
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