Healthcare Provider Details

I. General information

NPI: 1003141649
Provider Name (Legal Business Name): WOMEN TAKING CARE OF WOMEN PLUS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2009
Last Update Date: 10/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1357 CARMICHAEL WAY
MONTGOMERY AL
36106-3629
US

IV. Provider business mailing address

1357 CARMICHAEL WAY
MONTGOMERY AL
36106-3629
US

V. Phone/Fax

Practice location:
  • Phone: 334-356-7749
  • Fax: 334-356-7758
Mailing address:
  • Phone: 334-356-7749
  • Fax: 334-356-7758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number12289
License Number StateAL

VIII. Authorized Official

Name: PATRICIA DARLENE ELLIOTT
Title or Position: PHYSICIAN
Credential: MD
Phone: 334-356-7749