Provider Demographics
NPI:1992874838
Name:OB GYN SERVICES INC
Entity type:Organization
Organization Name:OB GYN SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OB GYN SERVICES INC
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:RAHMAN
Authorized Official - Last Name:LANCIONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-695-1811
Mailing Address - Street 1:PO BOX 594
Mailing Address - Street 2:
Mailing Address - City:ST CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950
Mailing Address - Country:US
Mailing Address - Phone:740-695-1811
Mailing Address - Fax:740-695-3206
Practice Address - Street 1:106 PLAZA DRIVE
Practice Address - Street 2:
Practice Address - City:ST CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43906
Practice Address - Country:US
Practice Address - Phone:740-695-1811
Practice Address - Fax:740-695-3206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35051074G207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0611636Medicaid
WV1000681000Medicaid
G00751441Medicare ID - Type Unspecified
WV1000681000Medicaid