MEDICARE: EMPOWER WOMEN HEALTH CENTER PC

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	302F00000X	Exclusive Provider Organization	048674	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	GRP6384	OTHER	GA	MEDICARE GROUP

General Provider Information

NPI Number	:	1831389048
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPOWER WOMEN HEALTH CENTER PC

Provider Business Mailing Address
First Line	:	900 1ST ST
Second Line	:	SUITE A
City	:	MACON
State	:	GA
Zip	:	31201-6806
Country	:	US
Telephone Number	:	478-743-4030
Fax Number	:	478-743-4032

Provider Business Practice Location Address
First Line	:	900 1ST ST
Second Line	:	SUITE A
City	:	MACON
State	:	GA
Zip	:	31201-6806
Country	:	US
Telephone Number	:	478-743-4030
Fax Number	:	478-743-4032

Authorized Official
Title or Position	:	OB/GYN
Name	:	DR. KATHLEEN MONT-LOUIS
Credential	:	MD
Telephone Number	:	478-743-4030

Provider Enumeration Date	:	07/25/2007
Last Update Date	:	06/22/2020

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Directions to “EMPOWER WOMEN HEALTH CENTER PC ” Practice Location

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