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General NPI Number Information
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NPI Number | 1043572837
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Entity Type | Organization
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Legal Business Name | PREMIER WOMEN'S CARE
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Dates
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Enumeration Date | 06/08/2012
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Last Update Date | 08/30/2012
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Provider Practice Location Address
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Address Line | 1995 HIGHWAY 51 S SUITE 112
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City | COVINGTON
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State | TN
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Zip | 38019-3635
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Country | US
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Telephone | 901-476-9311
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Fax | 901-476-8022
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Provider Business Mailing Address
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Address Line | 1995 HIGHWAY 51 S SUITE 112
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City | COVINGTON
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State | TN
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Zip | 38019-3635
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Country | US
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Telephone | 901-476-9311
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Fax | 901-476-8022
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS J CARUTHERS JR.
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Credential | MD
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Telephone | 901-476-9311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 000029623
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License Number State | TN
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