Healthcare Provider Details
I. General information
NPI: 1548995772
Provider Name (Legal Business Name): EVANS WOMEN'S CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/21/2022
Last Update Date: 07/21/2022
Certification Date: 07/21/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3493 VETERANS DR N STE A
HUNTINGDON TN
38344-6232
US
IV. Provider business mailing address
PO BOX 465
HUNTINGDON TN
38344-0465
US
V. Phone/Fax
- Phone: 731-986-2933
- Fax: 731-986-2938
- Phone: 731-986-2933
- Fax: 731-986-2938
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.
PAMELA
RUTH
EVANS
Title or Position: MD/OWNER
Credential: MD
Phone: 731-986-2933