Provider Demographics
NPI:1538197454
Name:JEFFERSON OB GYN LTD
Entity type:Organization
Organization Name:JEFFERSON OB GYN LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:COSNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-977-4488
Mailing Address - Street 1:600 PETER JEFFERSON PARKWAY
Mailing Address - Street 2:STE 290
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911
Mailing Address - Country:US
Mailing Address - Phone:434-977-4488
Mailing Address - Fax:434-977-6103
Practice Address - Street 1:600 PETER JEFFERSON PARKWAY
Practice Address - Street 2:STE 290
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911
Practice Address - Country:US
Practice Address - Phone:434-977-4488
Practice Address - Fax:434-977-6103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty