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Southside Ob-gyn, Inc.
Specialist in Petersburg, Virginia
NPI 1316150006

Southside Ob-gyn, Inc. is a Specialist based in Petersburg, VA. Southside Ob-gyn, Inc. practices in Petersburg, VA. The NPI Number for Southside Ob-gyn, Inc. is 1316150006 and holds a License No. 0101029081 (Virginia).

The current practice location address for Southside Ob-gyn, Inc. is 600 S Sycamore St, Petersburg, VA and can be reached out via phone at 804-732-0136 and via fax at 804-861-9661.

Location: 600 S Sycamore St, Petersburg, VA, 23803-5815
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1316150006
Provider Name
Southside Ob-gyn, Inc.
Credential
Provider Entity Type
Organization
Address
600 S Sycamore St, Petersburg, VA, 23803-5815
Phone Number
804-732-0136
Fax Number
804-861-9661
Provider Enumeration Date
05/08/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
213198 01 VA MDIPA OPTIMUM CHOICE
212033 01 VA CIGNA
070725 01 VA ANTHEM
institution
Provider Business Practice Location Address Details
Address
600 S Sycamore St
City
Petersburg
State
Virginia
Zip
23803-5815
Phone Number
804-732-0136
Fax Number
804-861-9661
person
Provider Business Mailing Address Details
Address
600 S Sycamore St
City
Petersburg
State
Virginia
Zip
23803-5815
Phone Number
804-732-0136
Fax Number
804-861-9661
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
0101029081 (Virginia)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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