SOUTHSIDE OB/GYN, P.C. - NPI 1407024557 - Obstetrics & Gynecology in Richmond Hill, GA

Q: What is Southside Ob/Gyn, P.C.'s NPI number?

The NPI number for Southside Ob/Gyn, P.C. is 1407024557. It was assigned to this organization in the NPPES registry on February 12, 2008.

Q: What is Southside Ob/Gyn, P.C.'s specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

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About Southside Ob/gyn, P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHSIDE OB/GYN, P.C. (NPI 1407024557) is a healthcare organization registered as an obstetrics & gynecology in Richmond Hill, Georgia and active in the NPI registry since February 2008. The organization holds a CLIA Microscopy certificate valid through August 31, 2026 and lists Francisco A. Dueno, President, as its authorized official.

NPPES Registry Identity

NPI1407024557

Entity TypeOrganization

Primary Taxonomy207V00000X

Legal Business NameSOUTHSIDE OB/GYN, P.C.

Location Address9390 FORD AVE, SUITE 4Richmond Hill, GA 31324-6421

Mailing AddressPo Box 1117Richmond Hill, GA 31324-1117 · (912) 756-3404 · Fax (912) 756-2156

Phone(912) 756-3404

Fax(912) 756-6352

Organization SubpartNo

Authorized OfficialFrancisco A. DuenoPresident · (912) 656-3533

Enumeration DateFebruary 12, 2008

Last NPPES UpdateMarch 22, 2017

✔ NPI 1407024557 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

Definition

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.

9390 FORD AVE, Richmond Hill, GA 31324

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Other Identifiers 1

Medicare PINGRP109GA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 11D0264467

Southside Ob/Gyn · Richmond Hill, GA

Active · expires Aug 31, 2026

CLIA Number11D0264467

Laboratory TypePhysician Office

Certificate Effective DateSeptember 1, 2024

Certificate Expiration DateAugust 31, 2026

Laboratory DirectorFrancisco A. Dueno

Laboratory Phone(912) 756-3404

Laboratory LocationSouthside Ob/Gyn10055 Ford Avenue, Suite 5 B, Richmond Hill, GA 31324

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LARHONDA JENKINS

Social Worker (Clinical)