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General NPI Number Information
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NPI Number | 1841290384
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Entity Type | Organization
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Legal Business Name | WOMENS HEALTHCARE PHYSICIANS PA
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Dates
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Enumeration Date | 07/27/2005
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Last Update Date | 10/27/2008
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Provider Practice Location Address
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Address Line | 775 1ST AVE N
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City | NAPLES
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State | FL
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Zip | 34102-6005
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Country | US
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Telephone | 239-262-3399
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Fax | 239-261-1189
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Provider Business Mailing Address
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Address Line | 775 1ST AVE N
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City | NAPLES
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State | FL
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Zip | 34102-6005
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Country | US
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Telephone | 239-262-3399
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Fax | 239-261-1189
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Authorized Official
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Title or Position | PRESIDENT
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Name | WALLACE W MCLEAN JR.
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Credential | MD
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Telephone | 239-262-3399
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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 | ME0025809
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License Number State | FL
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