Healthcare Provider Details

I. General information

NPI: 1053221846
Provider Name (Legal Business Name): SOUTHERN WOMEN'S HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 RIVER OAKS DR STE 320
FLOWOOD MS
39232-9512
US

IV. Provider business mailing address

PO BOX 35473
BELFAST ME
04915-0632
US

V. Phone/Fax

Practice location:
  • Phone: 601-932-1400
  • Fax:
Mailing address:
  • Phone: 248-988-3550
  • Fax:

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: BARBIE MENEGAN
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 518-769-3666