Provider Demographics
NPI:1366185696
Name:REPRODUCTIVE ENDOCRINOLOGY & GYNECOLOGY
Entity type:Organization
Organization Name:REPRODUCTIVE ENDOCRINOLOGY & GYNECOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:R
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-370-1817
Mailing Address - Street 1:1105 COLQUITT AVE NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30307-1921
Mailing Address - Country:US
Mailing Address - Phone:404-370-1817
Mailing Address - Fax:404-591-8909
Practice Address - Street 1:1800 PEACHTREE ST NW STE 640
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-2555
Practice Address - Country:US
Practice Address - Phone:404-370-1817
Practice Address - Fax:404-591-8909
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY GROUP, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty