Provider Demographics
NPI:1902880990
Name:ALL WOMEN OB/GYN, PSC
Entity Type:Organization
Organization Name:ALL WOMEN OB/GYN, PSC
Other - Org Name:WOMEN'S HEALTHCARE, PSC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TESS
Authorized Official - Middle Name:
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-895-6559
Mailing Address - Street 1:4010 DUPONT CIR
Mailing Address - Street 2:SUITE L-07
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4812
Mailing Address - Country:US
Mailing Address - Phone:502-895-6559
Mailing Address - Fax:502-895-8994
Practice Address - Street 1:4010 DUPONT CIR
Practice Address - Street 2:SUITE L-07
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4812
Practice Address - Country:US
Practice Address - Phone:502-895-6559
Practice Address - Fax:502-895-8994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-02
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2697Medicare UPIN