Premier Cornerstone Management, LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

0101244776 Issued in VA

Legal business name

PREMIER CORNERSTONE MANAGEMENT, LLC

Practice address

66 Parker St
Reynolds, GA 31076-2943

Phone

(478) 847-4690

NPI assigned

Jan 25, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Tawanna O'Pal Gordon, M.D.

Title

Owner

Phone

(229) 894-7734

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1264377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280361600000",
    "number": "1992036396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 272",
            "city": "REYNOLDS",
            "state": "GA",
            "postal_code": "310760272",
            "telephone_number": "478-847-4690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 PARKER ST",
            "city": "REYNOLDS",
            "state": "GA",
            "postal_code": "310762943",
            "telephone_number": "478-847-4690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER CORNERSTONE MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-25",
        "last_updated": "2010-07-29",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "TAWANNA",
        "authorized_official_middle_name": "O'PAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-894-7734",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101244776",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "055753",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD424859",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laspanya Hunter
• Jonathan Julian Knight, PHARMD
• Tammi Martin Knight, PHARMD
• Macon County Medical Center
• Randall Colby Nelson, AGNP-C
• Reynolds Medical Clinic
• Brandi Dawn Rodriguez, NP-BC
• Taylor County Drug Co Inc

• Obstetrics & Gynecology Physician in Reynolds, GA
• Providers in Reynolds, GA by specialty
• Obstetrics & Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.