Provider Demographics
NPI:1730148396
Name:WOMENS HEALTH SPECIALISTS,PA
Entity type:Organization
Organization Name:WOMENS HEALTH SPECIALISTS,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:T
Authorized Official - Last Name:WHITBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-535-1414
Mailing Address - Street 1:1381 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-5130
Mailing Address - Country:US
Mailing Address - Phone:252-535-1414
Mailing Address - Fax:252-519-0655
Practice Address - Street 1:1381 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-5130
Practice Address - Country:US
Practice Address - Phone:252-535-1414
Practice Address - Fax:252-519-0655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-22
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9500144207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89014K4Medicaid