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General NPI Number Information
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NPI Number | 1285801621
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Entity Type | Organization
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Legal Business Name | WOMEN TO WOMEN GYNECOLOGY, P.C.
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Dates
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Enumeration Date | 05/14/2008
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Last Update Date | 05/14/2008
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Provider Practice Location Address
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Address Line | 1125 E WADE WATTS AVE SUITE A
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City | MCALESTER
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State | OK
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Zip | 74501-5625
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Country | US
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Telephone | 918-426-7776
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Fax | 918-426-7780
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Provider Business Mailing Address
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Address Line | 1125 E WADE WATTS AVE SUITE A
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City | MCALESTER
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State | OK
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Zip | 74501-5625
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Country | US
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Telephone | 918-426-7776
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Fax | 918-426-7780
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Authorized Official
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Title or Position | OWNER / PHYSICIAN
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Name | MARCIA ANN GILLESPIE
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Credential | M.D.
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Telephone | 918-426-7776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 25235
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License Number State | OK
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