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General NPI Number Information
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NPI Number | 1255867933
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Entity Type | Organization
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Legal Business Name | TULLAHOMA WOMEN'S HEALTH
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Dates
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Enumeration Date | 05/02/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 707 KINGS LN
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City | TULLAHOMA
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State | TN
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Zip | 37388-5372
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Country | US
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Telephone | 931-393-3484
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Fax | 931-461-1171
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Provider Business Mailing Address
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Address Line | 707 KINGS LN
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City | TULLAHOMA
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State | TN
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Zip | 37388-5372
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Country | US
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Telephone | 931-393-3484
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Fax | 931-461-1171
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Authorized Official
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Title or Position | OWNER
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Name | DR. HOWARD MATHER BENNETT
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Credential | MD
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Telephone | 931-434-4068
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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