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WELLSTAR KENNESTONE OB/GYN LLC NPI 1548216203


NPI Information

NPI: 1548216203
Provider Name: WELLSTAR KENNESTONE OB/GYN, LLC
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization

CLIA Number: 11D2019890

Address:
2230 TOWNE LAKE PKWY
BUILDING 500, SUITE 100
WOODSTOCK, GA
ZIP 30189
Phone: (678) 445-5941
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WELLSTAR KENNESTONE OB/GYN, LLC is an obstetrics gynecology in Woodstock, 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. WELLSTAR KENNESTONE OB/GYN, LLC NPI is 1548216203. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2230 TOWNE LAKE PKWY
BUILDING 500, SUITE 100
WOODSTOCK, GA
ZIP 30189-540
Phone: (678) 445-5941
Fax: (678) 445-5950

The provider's authorized official is Nicole Ashe .
The authorized official title is Executive Director Of Finance and has the following contact phone number (770) 792-5261.

The CLIA number assigned to this NPI record is 11D2019890 - other - med imaging ctr with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/25/2006 and was last updated on 7/14/2008.


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 & GynecologyYes

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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