1902880990 NPI number — ALL WOMEN OB/GYN, PSC

Table of content: (NPI 1902880990)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902880990 NPI number — ALL WOMEN OB/GYN, PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALL WOMEN OB/GYN, PSC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WOMEN'S HEALTHCARE, PSC
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902880990
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/24/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4010 DUPONT CIR
Provider Second Line Business Mailing Address:
SUITE L-07
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40207-4812
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-895-6559
Provider Business Mailing Address Fax Number:
502-895-8994

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4010 DUPONT CIR
Provider Second Line Business Practice Location Address:
SUITE L-07
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40207-4812
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-895-6559
Provider Business Practice Location Address Fax Number:
502-895-8994
Provider Enumeration Date:
12/02/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WHEELER
Authorized Official First Name:
TESS
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE MANAGER
Authorized Official Telephone Number:
502-895-6559

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)