Healthcare Provider Details

I. General information

NPI: 1497821185
Provider Name (Legal Business Name): WOMENS CARE CENTER OF MEMPHIS,MPLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7705 POPLAR AVE SUITE 330
GERMANTOWN TN
38138-3930
US

IV. Provider business mailing address

7705 POPLAR AVE SUITE 330
GERMANTOWN TN
38138-3930
US

V. Phone/Fax

Practice location:
  • Phone: 901-682-0630
  • Fax: 901-312-9696
Mailing address:
  • Phone: 901-682-0630
  • Fax: 901-312-9696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: SHARON STONE
Title or Position: ADMINISTRATOR
Credential:
Phone: 901-682-0630