Provider Demographics
NPI:1144396581
Name:OB-GYN ASSOCIATES, PA
Entity type:Organization
Organization Name:OB-GYN ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GOODMAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:ESPY
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:770-422-8700
Mailing Address - Street 1:699 CHURCH ST NE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1110
Mailing Address - Country:US
Mailing Address - Phone:770-422-8700
Mailing Address - Fax:770-425-7601
Practice Address - Street 1:100 STONEFOREST DR
Practice Address - Street 2:SUITE 310
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-4880
Practice Address - Country:US
Practice Address - Phone:678-445-3555
Practice Address - Fax:678-445-7358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty