Provider Demographics
NPI:1962413260
Name:OBSTETRICS & GYNECOLOGY, PA
Entity type:Organization
Organization Name:OBSTETRICS & GYNECOLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:MARSHALL
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:478-922-3191
Mailing Address - Street 1:105 BRIARCLIFF RD
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-4039
Mailing Address - Country:US
Mailing Address - Phone:478-922-3191
Mailing Address - Fax:478-922-6330
Practice Address - Street 1:105 BRIARCLIFF RD
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-4099
Practice Address - Country:US
Practice Address - Phone:478-922-3191
Practice Address - Fax:478-922-6330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA017871207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty