MEDICARE: WOMENS GENERATIONAL CARE OBSTETRICS & GYNECOLOGY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275543241
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOMENS GENERATIONAL CARE OBSTETRICS & GYNECOLOGY PLLC

Provider Business Mailing Address
First Line	:	3950 NEW COVINGTON PIKE
Second Line	:	#220
City	:	MEMPHIS
State	:	TN
Zip	:	38128-2591
Country	:	US
Telephone Number	:	901-259-4100
Fax Number	:	901-259-4140

Provider Business Practice Location Address
First Line	:	3950 NEW COVINGTON PIKE
Second Line	:	#220
City	:	MEMPHIS
State	:	TN
Zip	:	38128-2591
Country	:	US
Telephone Number	:	901-259-4100
Fax Number	:	901-259-4140

Authorized Official
Title or Position	:	MD/OWNER
Name	:	GINA S WILSON
Credential	:	M.D.
Telephone Number	:	901-259-4100

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	07/10/2007

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