Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Providence OBGYN LLC

Organization Obstetrics & Gynecology Physician · NPI 1124750369

Providence OBGYN LLC is an Obstetrics & Gynecology Physician in Dublin, Georgia. Works from 2 locations. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

206 Fairview Park Dr
Dublin, GA 31021-2547
Phone: (478) 246-4304
Fax: (478) 246-4282
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 227 Industrial Blvd, Dublin, GA 31021-2969 — (478) 246-4304

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X

Record details

NPI number1124750369
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lauri Bullen — Sole Partner · (843) 614-9917
NPI enumeratedJune 27, 2022
Last updated in NPPESNovember 17, 2025
Certification dateNovember 17, 2025
Mailing address206 Fairview Park Dr, Dublin, GA 31021-2547

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