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LIFEBOAT MEDICAL ASSOCIATES 2 LLC NPI 1346756129


NPI Information

NPI: 1346756129
Provider Name: LIFEBOAT MEDICAL ASSOCIATES 2, LLC
Classification: Obstetrics & Gynecology - 207VG0400X
Entity Type: Organization

Specialization: Gynecology

CLIA Number: 11D0955611

Address:
1201 GEORGIAN PARK
PEACHTREE CITY, GA
ZIP 30269
Phone: (770) 631-4873
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LIFEBOAT MEDICAL ASSOCIATES 2, LLC is a gynecology obstetrics gynecology in Peachtree City, GA. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee LIFEBOAT MEDICAL ASSOCIATES 2, LLC NPI is 1346756129. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1201 GEORGIAN PARK
PEACHTREE CITY, GA
ZIP 30269-972
Phone: (770) 631-4873
Fax: (770) 631-0684

The provider's authorized official is Shelley Depp .
The authorized official title is Payer Relations Liaison and has the following contact phone number (770) 579-2626.

The CLIA number assigned to this NPI record is 11D0955611 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/15/2017 and was last updated on 12/15/2017.


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
1207VG0400XObstetrics & GynecologyGynecologyYes

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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