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NPI Code Detail

MEDICARE: WOMANS HEALTHCARE ASSOCIATES PC

MEDICARE: WOMANS HEALTHCARE ASSOCIATES PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528344207
Entity Type Code : Organization
Provider Name (Legal Business Name) : WOMANS HEALTHCARE ASSOCIATES PC
Provider Business Mailing Address
First Line : PO BOX 7010
Second Line :
City : LAFAYETTE
State : IN
Zip : 47903-7010
Country : US
Telephone Number : 765-428-5888
Fax Number : 765-428-5897
Provider Business Practice Location Address
First Line : 3774 BAYLEY DR
Second Line : SUITE B
City : LAFAYETTE
State : IN
Zip : 47905-8651
Country : US
Telephone Number : 765-807-2280
Fax Number : 765-807-2281
Authorized Official
Title or Position : ADMINISTRATOR
Name : ROBERT IDESON
Credential :
Telephone Number : 765-428-5888
Provider Enumeration Date : 10/26/2011
Last Update Date : 08/25/2015

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Directions to “WOMANS HEALTHCARE ASSOCIATES PC ” Practice Location

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