MEDICARE: CROSSVILLE WOMEN'S CENTER PLC

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	207V00000X	Obstetrics & Gynecology Physician	MD0000023982	TN

General Provider Information

NPI Number	:	1568636157
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CROSSVILLE WOMEN'S CENTER PLC

Provider Business Mailing Address
First Line	:	49 CLEVELAND ST STE 240
Second Line	:
City	:	CROSSVILLE
State	:	TN
Zip	:	38555-2858
Country	:	US
Telephone Number	:	931-456-5814
Fax Number	:

Provider Business Practice Location Address
First Line	:	49 CLEVELAND ST STE 240
Second Line	:
City	:	CROSSVILLE
State	:	TN
Zip	:	38555-2858
Country	:	US
Telephone Number	:	931-456-5814
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. KIMBERLY M CLAYPOOL
Credential	:	M.D.
Telephone Number	:	931-456-5814

Provider Enumeration Date	:	04/15/2008
Last Update Date	:	04/15/2008

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