Healthcare Provider Details
I. General information
NPI: 1891521167
Provider Name (Legal Business Name): EPIPHANY WOMEN'S HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/12/2024
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8050 SPRING RUN DR
FAIRHOPE AL
36532-3854
US
IV. Provider business mailing address
82 PLANTATION POINTE
FAIRHOPE AL
36532-2962
US
V. Phone/Fax
- Phone: 251-990-1950
- Fax:
- Phone: 407-832-4501
- Fax: 309-204-6991
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
WILLIAM
M
BOYD
JR.
Title or Position: OWNER
Credential: DO, MD
Phone: 309-264-2046