Cobb GYN Clinic, P.C.

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

014251 Issued in GA

Legal business name

COBB GYN CLINIC, P.C.

Practice address

3327 Highway 5
Douglasville, GA 30135-6844

Phone

(770) 577-7030

Fax

(770) 577-6844

NPI assigned

Nov 16, 2006

Last updated

Sep 28, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Teresa L Frank

Title

Office Manager

Phone

(770) 577-7030

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Cobb Gyn Clinic, P.A. Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285632000000",
    "number": "1922171081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3327 HIGHWAY 5",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301352307",
            "telephone_number": "770-577-7030",
            "fax_number": "770-577-6844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3327 HIGHWAY 5",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301356844",
            "telephone_number": "770-577-7030",
            "fax_number": "770-577-6844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBB GYN CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2010-09-28",
        "status": "A",
        "authorized_official_last_name": "FRANK",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-577-7030"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "015528",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "GA",
            "license": "014251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00065029A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cobb Gyn Clinic, P.A.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Gynecology Physician in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.