Healthcare Provider Details
I. General information
NPI: 1417926676
Provider Name (Legal Business Name): WOMEN'S HEALTH ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1601 E BROADWAY SUITE 100
COLUMBIA MO
65201-8020
US
IV. Provider business mailing address
1601 E BROADWAY SUITE 100
COLUMBIA MO
65201-8020
US
V. Phone/Fax
- Phone: 573-443-8796
- Fax: 573-875-3949
- Phone: 573-443-8796
- Fax: 573-875-3949
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.
DAVID
W
MORETON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 573-443-8796