Healthcare Provider Details

I. General information

NPI: 1700096013
Provider Name (Legal Business Name): PIEDMONT HEALTHCARE FOR WOMEN GREENSBORO OB GYN DIVISION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 N ELAM AVE STE 101
GREENSBORO NC
27403-1142
US

IV. Provider business mailing address

510 N ELAM AVE STE 101
GREENSBORO NC
27403-1142
US

V. Phone/Fax

Practice location:
  • Phone: 336-854-8800
  • Fax: 336-299-4308
Mailing address:
  • Phone: 336-854-8800
  • Fax: 336-299-4308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS FRANKLIN HENLEY
Title or Position: PRESIDENT
Credential: MD
Phone: 336-854-8800