OLD NATIONAL OB- GYN, LLC is a gynecology obstetrics gynecology in College Park, GA. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions.
Source: National Uniform Claim Committee OLD NATIONAL OB- GYN, LLC NPI is 1851426878. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
6210 OLD NATIONAL HWY
COLLEGE PARK, GA
ZIP 30349-330
Phone: (770) 991-7552
The provider's authorized official is Tyrone C Malloy .
The authorized official title is Owner and has the following contact phone number (770) 991-7552.
The CLIA number assigned to this NPI record is 11D0918294 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 2/22/2007 and was last updated on 5/3/2010.