EAGLES LANDING OB GYN ASSOCIATES PC NPI 1649225517

NPI Information

  • NPI: 1649225517
  • Provider Name: EAGLES LANDING OB GYN ASSOCIATES, PC
  • Classification: Obstetrics & Gynecology - 207V00000X
  • Entity Type: Organization
  • CLIA Number: 11D0258205
  • Address: 3333 JODECO RD STE D
    MCDONOUGH, GA
    ZIP 30253
  • Phone: (404) 455-0110

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NPI Details

EAGLES LANDING OB GYN ASSOCIATES, PC is an obstetrics gynecology in Mcdonough, GA. The provider is 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. EAGLES LANDING OB GYN ASSOCIATES, PC NPI is 1649225517. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3333 JODECO RD STE D
MCDONOUGH, GA
ZIP 30253-319
Phone: (404) 455-0110
Fax: (770) 474-7832

The provider's authorized official is Jackie Livingston .
The authorized official title is Office Manager and has the following contact phone number (770) 474-1919.

The CLIA number assigned to this NPI record is 11D0258205 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/22/2006 and was last updated on 1/31/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207V00000XObstetrics & Gynecology036810GEORGIANo
2207V00000XObstetrics & Gynecology043639GEORGIANo
3207V00000XObstetrics & Gynecology046612GEORGIANo
4207V00000XObstetrics & Gynecology042399GEORGIANo
5207V00000XObstetrics & Gynecology057739GEORGIANo
6207V00000XObstetrics & Gynecology056295GEORGIANo
7207V00000XObstetrics & Gynecology65352GEORGIANo
8207V00000XObstetrics & GynecologyNo
9363LW0102XNurse PractitionerWomen's HealthRN070819 NPGEORGIANo
10367A00000XAdvanced Practice MidwifeRN119659GEORGIANo
11207V00000XObstetrics & Gynecology032893GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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