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General NPI Number Information
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NPI Number | 1881842821
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Entity Type | Organization
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Legal Business Name | UPSON WOMENS SERVICES LLC
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 09/04/2008
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Provider Practice Location Address
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Address Line | 214 CHEROKEE RD
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City | THOMASTON
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State | GA
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Zip | 30286-3402
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Country | US
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Telephone | 706-647-9627
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Fax |
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Provider Business Mailing Address
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Address Line | 214 CHEROKEE RD
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City | THOMASTON
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State | GA
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Zip | 30286-3402
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Country | US
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Telephone | 706-647-9627
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Fax |
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Authorized Official
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Title or Position | REGISTERED AGENT
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Name | MR. JOHN H WILLIAMS
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Credential |
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Telephone | 706-647-8111
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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 | GA
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