Providence Obgyn LLC

NPI #1124750369 in Dublin, Georgia

Provider Information

NPI Number: 1124750369
Entity Type: Organization
Organization Name: Providence Obgyn LLC
Primary Specialty: Obstetrics & Gynecology
Enumeration Date: Jun 27, 2022
Last Updated: Nov 17, 2025

Practice Location

Address: 206 FAIRVIEW PARK DR
City: Dublin
State: Georgia
ZIP Code: 31021-2547
Phone: (478) 246-4304

Authorized Official

Name: LAURI BULLEN, MD
Title: SOLE PARTNER
Phone: (843) 614-9917

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Obstetrics & Gynecology	207V00000X	Primary

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