Unknown Individual – Obstetrics & Gynecology Physician, NPI 1336111012

Unknown Individual is a healthcare provider. based in Cordele, Georgia. specializing in Obstetrics & Gynecology Physician. They hold a License No. 030713 (GA). The NPI Number for Unknown Individual is 1336111012

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1336111012
Phone
(229) 276-3038
Address
PO BOX 5007
Deactivation Date
16 June 2021
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Cordele Post Office, 11th Avenue East, Cordele, Crisp County, Georgia, 31010, United States

    CORDELE, GA 31010

    Phone: (229) 276-3038

    Fax: (229) 276-3631

    Type: Mailing

  • 910, 5th Street North, Cordele, Crisp County, Georgia, 31015, United States

    CORDELE, GA 310153254

    Phone: (229) 276-3038

    Fax: (229) 276-3631

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 31010)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1336111012 for Unknown Individual, then check state licensing separately.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Obstetrics & Gynecology Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual based?
Unknown Individual is tied to Cordele, Georgia in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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