Provider Demographics
NPI:1154378198
Name:CARTERSVILLE OB-GYN ASSOC PC
Entity type:Organization
Organization Name:CARTERSVILLE OB-GYN ASSOC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROSSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-605-9371
Mailing Address - Street 1:958 JOE FRANK HARRIS PKWY SE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-2151
Mailing Address - Country:US
Mailing Address - Phone:770-386-4824
Mailing Address - Fax:770-386-4220
Practice Address - Street 1:958 JOE FRANK HARRIS PKWY SE
Practice Address - Street 2:SUITE 102
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-2158
Practice Address - Country:US
Practice Address - Phone:770-386-4824
Practice Address - Fax:770-386-4220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA22993207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty