Providence OBGYN LLC
NPI 1124750369ActiveOrganization· Obstetrics & Gynecology· Dublin, GA
Obstetrics & Gynecology in Dublin, Georgia, registered in NPPES in June 2022. The authorized official on file is Lauri Bullen, MD, Sole Partner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1124750369 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 27, 2022 |
| Last updated in NPPES | Nov 17, 2025 |
| Certified by provider | Nov 17, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Obstetrics & Gynecology Primary | 207V00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (GA) |
|---|
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