Provider Demographics
NPI:1154435584
Name:EASTERN OBSTETRICS AND GYNECOLOGY, P.C.
Entity type:Organization
Organization Name:EASTERN OBSTETRICS AND GYNECOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING SHAREHOLDER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:DOLLAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-838-3036
Mailing Address - Street 1:48 MEDICAL PARK DR E
Mailing Address - Street 2:SUITE 355
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3400
Mailing Address - Country:US
Mailing Address - Phone:205-838-3036
Mailing Address - Fax:205-838-5832
Practice Address - Street 1:48 MEDICAL PARK DR E
Practice Address - Street 2:SUITE 355
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3400
Practice Address - Country:US
Practice Address - Phone:205-838-3036
Practice Address - Fax:205-838-5832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty