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General NPI Number Information
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NPI Number | 1396097549
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Entity Type | Organization
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Legal Business Name | OBSTETRICS & GYNECOLOGY SOUTH, INC
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Dates
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Enumeration Date | 10/12/2012
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Last Update Date | 09/26/2019
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Provider Practice Location Address
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Address Line | 2510 COMMONS BLVD STE 200A
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City | BEAVERCREEK
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State | OH
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Zip | 45431-3829
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Country | US
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Telephone | 937-558-3088
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Fax |
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Provider Business Mailing Address
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Address Line | 3533 SOUTHERN BLVD STE 4600
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City | KETTERING
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State | OH
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Zip | 45429-1264
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Country | US
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Telephone | 937-296-0167
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Fax | 937-297-2330
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Authorized Official
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Title or Position | PRESIDENT
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Name | ART ALTMAN
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Credential | MD
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Telephone | 937-296-0167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 35.043084
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License Number State | OH
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