NPI | 1689759581 |
---|---|
Doing Business As | MIDTOWN OB GYN |
Entity Type | Organization |
Authorized Contact | SERENA DAVIS TIDWELL President 706-320-2547 |
Organization Subpart ? | No |
Primary Taxonomy | 305S00000X Point of Service (Licence: GA 051192) |
Enumeration Date | 2006-10-26 |
Last Update Date | 2015-01-20 |