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PEACHTREE FAYETTE WOMEN'S SPECIALISTS NPI 1164475703


NPI Information

NPI: 1164475703
Provider Name: PEACHTREE FAYETTE WOMEN'S SPECIALISTS
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization

CLIA Number: 11D2283413

Address:
1267 HIGHWAY 54 W
SUITE 3200
FAYETTEVILLE, GA
ZIP 30214
Phone: (770) 632-9900
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PEACHTREE FAYETTE WOMEN'S SPECIALISTS is an obstetrics gynecology in Fayetteville, GA. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. PEACHTREE FAYETTE WOMEN'S SPECIALISTS NPI is 1164475703. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1267 HIGHWAY 54 W
SUITE 3200
FAYETTEVILLE, GA
ZIP 30214-526
Phone: (770) 632-9900
Fax: (770) 632-9997

The provider's authorized official is Michele R Brandt .
The authorized official title is R.n., Practice Manager and has the following contact phone number (770) 632-9900.

The CLIA number assigned to this NPI record is 11D2283413 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/17/2006 and was last updated on 10/2/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207V00000XObstetrics & Gynecology20002063GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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