GYN & OB OF DEKALB, P.C. (NPI# 1467683342) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467683342 |
| Entity Type | Organization |
| Organization Name | GYN & OB OF DEKALB, P.C. |
| Practice Address |
1805 Parke Plaza Cir Suite 102 Stone Mountain GA 30087-3637 |
| Mailing Address |
2801 N Decatur Rd Suite 190 Decatur GA 30033-5949 |
| Practice Telephone | 7704699961 |
| Practice Fax Number | 7704130030 |
| Mailing Telephone | 4042999307 |
| Mailing Fax Number | 4042999309 |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2009-07-27 |
| Authorized Official Name | DR. WILLIAM LANE HUTCHINSON (PRESIDENT) |
| Authorized Official Telephone | 4042999307 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | GYN & OB OF DEKALB, P.C. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457598468 | Gyn & Ob of Dekalb, P.C. | Obstetrics & Gynecology | 2801 N Decatur Rd, Suite 190, Decatur, GA 30033-5949 | 2009-01-13 |
| Street Address |
1805 PARKE PLAZA CIR SUITE 102 |
| City | STONE MOUNTAIN |
| State | GA |
| Zip Code | 30087-3637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104810423 | Catherine Huggins Alexander | Family Medicine | 1805 Parke Plaza Cir, Suite 101, Stone Mountain, GA 30087-3498 | 2005-08-31 |
| 1205175262 | Carla N Cooke | Physician Assistant | 1805 Parke Plaza Cir, Suite 101, Stone Mountain, GA 30087-3637 | 2013-02-11 |
| 1154624013 | Kanani Daniels Floyd | Physician Assistant | 1805 Parke Plaza Cir, Suite 101, Stone Mountain, GA 30087-3637 | 2010-12-15 |
| 1770790602 | Shu-tsui Lan | Physician Assistant | 1805 Parke Plaza Cir, Suite 103, Stone Mountain, GA 30087-3498 | 2007-05-17 |
| 1518174036 | Northlake Pediatric Associates,pc | Pediatrics | 1805 Parke Plaza Cir, Suite 103, Stone Mountain, GA 30087-3498 | 2007-05-16 |
| 1053485037 | Stone Mountain Family Practice, PC | Family Medicine | 1805 Parke Plaza Cir, Suite 101, Stone Mountain, GA 30087-3498 | 2006-11-20 |
| 1730110370 | Edith J Dezoort | Pediatrics | 1805 Parke Plaza Cir, Ste 103, Stone Mountain, GA 30087 | 2006-07-05 |
| 1437195492 | Raymond Rosenberg | Pediatrics | 1805 Parke Plaza Cir, Ste 103, Stone Mountain, GA 30087 | 2006-06-20 |
| 1316998255 | Stanley M Tenenbaum | Pediatrics | 1805 Parke Plaza Cir, Ste 103, Stone Mountain, GA 30087 | 2006-05-15 |
| 1255325536 | Martha H Crenshaw | Family Medicine | 1805 Parke Plaza Cir, Suite 101, Stone Mountain, GA 30087-3498 | 2005-09-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477176394 | Optimal Choice Telehealth | General Practice | 1227 Rockbidge Rd Sw, Ste 208-354, Stone Mountain, GA 30087 | 2020-05-27 |
| 1245882943 | Lynell Williams | Counselor | 505 Lilburn-stone Mountain Road, Suite 235, Stone Mountain, GA 30087 | 2019-07-12 |
| 1003302688 | Mark Andrew Stevens | Physical Therapist | 1227 Rockbridge Rd Ste 402, Stone Mountain, GA 30087 | 2018-07-06 |
| 1154816825 | Tuan Minh Khong | Physician Assistant | 6301 Southland Rdg, Stone Mountain, GA 30087 | 2018-06-26 |
| 1215429881 | Stephanie Martin | Nurse Practitioner | 2720 S Rockbridge Rd, Stone Mountain, GA 30087 | 2018-05-30 |
| 1578979381 | Edmund Thomas Jr. | Dentist | 2536 Rockbridge Rd Ste 103, Stone Mountain, GA 30087 | 2014-07-02 |
| 1790027688 | Robert Fanning Eaves Jr. | General Practice | 5394 Leatherstocking Lane, Stone Mountain, GA 30087 | 2013-03-19 |
| 1609128917 | Mary Marlene Muse | Lactation Consultant, Non-RN | 510 Navarre Drive, Stone Mountain, GA 30087 | 2012-10-10 |
| 1457680704 | Cleo Evans | Counselor | 5638 Manassas Run, Stone Mountain, GA 30087 | 2009-12-16 |
| 1932348521 | Lawrence Randy Sheber | Dentist | 5500-a Lilburn Stone Mountain Road, Stone Mountain, GA 30087 | 2009-02-05 |
| Find all providers in zip 30087 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851604995 | Dekalb Women's Specialists | Obstetrics & Gynecology | 5295 Stone Mountain Hwy, Suite N, Stone Mountain, GA 30087-6416 | 2010-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639794001 | Stephanie Stokes | Obstetrics & Gynecology | 1120 15th St Ste Ba-7300, Augusta, GA 30912-0004 | 2020-06-11 |
| 1346865839 | Teodora Stoikov | Obstetrics & Gynecology | 1120 15th St # Ba-7411, Augusta, GA 30912-0004 | 2020-06-10 |
| 1477185221 | Metro Health and Wellness, LLC | Obstetrics & Gynecology | 2950 Stone Hogan Connector Rd Sw Bldg B, Atlanta, GA 30331-2837 | 2020-02-10 |
| 1437707783 | One Health Research Clinic Atlanta LLC | Obstetrics & Gynecology | 5880 Live Oak Pkwy Ste 160, Norcross, GA 30093-1742 | 2019-08-29 |
| 1528627650 | Suellen Anizia Romero De Mello Sa | Obstetrics & Gynecology | 1120 15th St # Ba-7310, Augusta, GA 30912-0004 | 2019-06-12 |
| 1457910069 | Taylor Mitchell Jones | Obstetrics & Gynecology | 1120 15th St # Ba-7300, Augusta, GA 30912-3300 | 2019-06-07 |
| 1871156687 | Alexandra Poch | Obstetrics & Gynecology | 1120 15th St # Ba7300, Augusta, GA 30912-0004 | 2019-04-17 |
| 1912485830 | Hilton Head Regional Physician Network - Georgia, LLC | Obstetrics & Gynecology | 1000 Towne Center Blvd Ste 604b, Pooler, GA 31322-4052 | 2018-08-02 |
| 1003302852 | Louis Wayne Goolsby | Obstetrics & Gynecology | 6605 Britt Rd, Macon, GA 31216-6031 | 2018-07-05 |
| 1508356395 | Hospital Authority of Liberty County | Obstetrics & Gynecology | 455 S Main St Ste 202, Hinesville, GA 31313-4354 | 2018-05-16 |
| Find all providers with the same taxonomy | ||||
| City | STONE MOUNTAIN |
| Zip Code | 30087 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.