1. Home
  2. Directory
  3. Georgia
  4. College Park
  5. Obstetrics Gynecology
  6. NPI Profile

OLD NATIONAL OB- GYN, LLC
NPI 1851426878
Obstetrics & Gynecology - Gynecology in College Park, GA

Active since February 22, 2007
6210 OLD NATIONAL HWY, COLLEGE PARK, GA 30349(770) 991-7552 Get Directions Write a Review

NPPES record last updated: May 3, 2010. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Old National Ob- Gyn, Llc NPPES

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

OLD NATIONAL OB- GYN, LLC (NPI 1851426878) is a healthcare organization registered as a gynecology in College Park, Georgia and active in the NPI registry since February 2007. The organization lists Tyrone C Malloy, Owner, as its authorized official.

NPPES Registry Identity

NPI1851426878
Entity TypeOrganization
Primary Taxonomy207VG0400X
Legal Business NameOLD NATIONAL OB- GYN, LLC
Location Address6210 OLD NATIONAL HWYCollege Park, GA 30349-4330
Mailing Address6210 Old National HwyCollege Park, GA 30349-4330 · (770) 991-7552
Phone(770) 991-7552
Organization SubpartNo
Authorized OfficialTyrone C MalloyOwner · (770) 991-7552
Enumeration DateFebruary 22, 2007
Last NPPES UpdateMay 3, 2010
✔ NPI 1851426878 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207VG0400X
License✔ Licensed in GA · 621111
Definition
A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee
6210 OLD NATIONAL HWY, College Park, GA 30349
Open in Google Maps ↗

Other Identifiers 1

Medicaid00022741MGA

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 of Waiver 11D0918294

Old National Gynecology · College Park, GA
Expired · Aug 4, 2026
CLIA Number11D0918294
Laboratory TypePhysician Office
Certificate Effective DateAugust 5, 2024
Certificate Expiration DateAugust 4, 2026
Laboratory DirectorDr. Tyrone C. Malloy
Laboratory Phone(404) 534-0035
Laboratory LocationOld National Gynecology6210 Old National Highway, College Park, GA 30349
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Old National Ob- Gyn, LLC's NPI number?

The NPI number for Old National Ob- Gyn, LLC is 1851426878. It was assigned to this organization in the NPPES registry on February 22, 2007.

Where is Old National Ob- Gyn, LLC located?

Old National Ob- Gyn, LLC is located at 6210 Old National Hwy, College Park, GA 30349. The listed phone number is (770) 991-7552.

What is Old National Ob- Gyn, LLC's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Gynecology, with taxonomy code 207VG0400X.

When was this NPI record last updated?

The NPPES record for Old National Ob- Gyn, LLC was last updated on May 3, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.