Basic Information
Provider Information
NPI: 1558548164
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COMBS
FirstName: JULIA
MiddleName: CARPER
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1306 STILLWOOD CHASE NE
Address2:  
City: ATLANTA
State: GA
PostalCode: 303062500
CountryCode: US
TelephoneNumber: 4042162955
FaxNumber:  
Practice Location
Address1: 275 COLLIER RD NW
Address2: SUITE 100-A
City: ATLANTA
State: GA
PostalCode: 303091709
CountryCode: US
TelephoneNumber: 4043521235
FaxNumber: 4046058805
Other Information
ProviderEnumerationDate: 01/25/2008
LastUpdateDate: 05/13/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X001365GAN Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207V00000X062322GAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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