Healthcare Provider Details

I. General information

NPI: 1053581843
Provider Name (Legal Business Name): WOMENS WELLNESS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2008
Last Update Date: 03/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PILOT MEDICAL DR SUITE 200
BIRMINGHAM AL
35235-3411
US

IV. Provider business mailing address

100 PILOT MEDICAL DR SUITE 200
BIRMINGHAM AL
35235-3411
US

V. Phone/Fax

Practice location:
  • Phone: 205-856-1117
  • Fax: 205-856-6117
Mailing address:
  • Phone: 205-856-1117
  • Fax: 205-856-6117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: LAURA A HORNE
Title or Position: OWNER
Credential: MD
Phone: 205-856-1117