Organization Name: | NORTH GEORGIA GYN |
NPI Number: | 1023082930 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES P HALEY (OWNER PRESIDENT) |
Mailing Address: | 3450 Acworth Due West Rd Nw Suite 380 Kennesaw |
State: | GA US |
Postal Code: | 30144 |
Phone Number: | 7709747010 |
Fax Number: | 7709751001 |
NPI Enumeration Date: | 02/15/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207VG0400X |
License Number: | 036769 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | Gynecology |
Taxonomy Definition: |