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General NPI Number Information
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NPI Number | 1700131836
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Entity Type | Organization
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Legal Business Name | ATLANTA PREMIER OB/GYN ASSOCIATES, PC
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Dates
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Enumeration Date | 07/15/2012
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Last Update Date | 12/30/2022
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Provider Practice Location Address
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Address Line | 764 MEMORIAL DR SE STE 101
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City | ATLANTA
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State | GA
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Zip | 30316-1573
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Country | US
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Telephone | 678-705-4900
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Fax | 678-705-5441
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Provider Business Mailing Address
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Address Line | 764 MEMORIAL DR SE STE 101
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City | ATLANTA
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State | GA
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Zip | 30316-1573
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Country | US
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Telephone | 678-705-4900
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Fax | 678-705-5441
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. TOSHA ROGERS
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Credential | D.O.
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Telephone | 678-705-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 064644
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License Number State | GA
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