Healthcare Provider Details

I. General information

NPI: 1053520502
Provider Name (Legal Business Name): WOMEN'S CLINIC OF ALEXANDRIA LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 11/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 MEDICAL CENTER DRIVE STE 300
ALEXANDRIA VA
71301-8124
US

IV. Provider business mailing address

501 MEDICAL CENTER DRIVE BOX 30114
ALEXANDRIA VA
71301-8124
US

V. Phone/Fax

Practice location:
  • Phone: 318-443-6336
  • Fax: 318-445-1597
Mailing address:
  • Phone: 318-443-6336
  • Fax: 318-445-1597

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: DR. GORDON S BOWERS
Title or Position: PHYSICIAN/OWNER
Credential: JR
Phone: 318-443-6336