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General NPI Number Information
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NPI Number | 1558415919
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Entity Type | Organization
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Legal Business Name | GRIFFIN OBGYN CLINIC PA
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 503 S 8TH STREET
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City | GRIFFIN
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State | GA
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Zip | 30224-4211
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Country | US
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Telephone | 770-227-5505
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Fax | 770-412-7881
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Provider Business Mailing Address
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Address Line | 503 S 8TH STREET
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City | GRIFFIN
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State | GA
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Zip | 30224-4211
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Country | US
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Telephone | 770-227-5505
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Fax | 770-412-7881
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. TAYLOR CHASTAIN
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Credential |
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Telephone | 770-227-5505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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