Basic Information
| Provider Information | |||||||||
| NPI: | 1730491747 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FIRST CHOICE OB/GYN. PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 507 S L ROGERS WELLS BLVD | ||||||||
| Address2: | SUITE C&D | ||||||||
| City: | GLASGOW | ||||||||
| State: | KY | ||||||||
| PostalCode: | 421411043 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2706512229 | ||||||||
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| Practice Location | |||||||||
| Address1: | 507 S L ROGERS WELLS BLVD | ||||||||
| Address2: | SUITE C&D | ||||||||
| City: | GLASGOW | ||||||||
| State: | KY | ||||||||
| PostalCode: | 421411043 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2706512229 | ||||||||
| FaxNumber: | 2706512236 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2010 | ||||||||
| LastUpdateDate: | 08/16/2010 | ||||||||
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| AuthorizedOfficialLastName: | SOUTH | ||||||||
| AuthorizedOfficialFirstName: | CHRISTY | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2706512229 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 42197 | KY | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.