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General NPI Number Information
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NPI Number | 1801924865
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Entity Type | Organization
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Legal Business Name | OB-GYN, INC
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 11/12/2008
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Provider Practice Location Address
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Address Line | 1018 HOSPITAL DR
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-7384
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Country | US
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Telephone | 770-507-4842
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Fax | 770-507-6964
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Provider Business Mailing Address
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Address Line | 1018 HOSPITAL DR
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-7384
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Country | US
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Telephone | 770-507-4842
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Fax | 770-507-6964
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MR. PATRICK IKE OJUKWU
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Credential | MD
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Telephone | 770-507-4842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 050047
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License Number State | GA
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