| NPI | 1215132527 |
|---|---|
| Doing Business As | EASTSIDE GYNECOLOGY |
| Entity Type | Organization |
| Authorized Contact | ROBERT EARL KELLEY Physician President 706-548-4424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2008-04-24 |