| Organization Name: | ELBERTON WOMEN'S SPECIALIST, LLC |
| NPI Number: | 1740372598 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID MICHAEL HAGINS (OWNER) |
| Mailing Address: | 41 Chestnut St Third Floor Elberton |
| State: | GA US |
| Postal Code: | 306351805 |
| Phone Number: | 7062131688 |
| Fax Number: | 7062131690 |
| NPI Enumeration Date: | 09/29/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VG0400X |
| License Number: | 024820 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Gynecology |
| Taxonomy Definition: | |