Healthcare Provider Details

I. General information

NPI: 1598709263
Provider Name (Legal Business Name): WOMENS HEALTH SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 05/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 WOLF TRAIL COVE
GERMANTOWN TN
38138
US

IV. Provider business mailing address

PO BOX 372 DEPT 10
MEMPHIS TN
38101-0372
US

V. Phone/Fax

Practice location:
  • Phone: 901-682-9222
  • Fax: 901-682-9505
Mailing address:
  • Phone: 901-202-6120
  • Fax: 901-202-6117

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: ERIC W GIBSON
Title or Position: CEO
Credential:
Phone: 901-373-8949