Healthcare Provider Details

I. General information

NPI: 1578572632
Provider Name (Legal Business Name): HENDERSON & WALTON WOMENS CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 08/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

806 ST VINCENTS DRIVE SUITE 500
BIRMINGHAM AL
35205
US

IV. Provider business mailing address

806 ST VINCENTS DRIVE SUITE 500
BIRMINGHAM AL
35205
US

V. Phone/Fax

Practice location:
  • Phone: 205-930-1800
  • Fax: 205-930-1817
Mailing address:
  • Phone: 205-930-1800
  • Fax: 205-930-1817

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: MRS. BELINDA C CORNELIUS
Title or Position: DIR OF FINANCE ADMIN
Credential:
Phone: 205-930-1827