Provider Demographics
NPI:1003001066
Name:WOMENS HEALTH SERVICES CHATTANOOGA PC
Entity Type:Organization
Organization Name:WOMENS HEALTH SERVICES CHATTANOOGA PC
Other - Org Name:ASSOCIATES IN WOMENS HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:T
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-861-4508
Mailing Address - Street 1:6845 MOUNTAIN VIEW RD
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6561
Mailing Address - Country:US
Mailing Address - Phone:423-910-0896
Mailing Address - Fax:423-910-1183
Practice Address - Street 1:6845 MOUNTAIN VIEW RD
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-6561
Practice Address - Country:US
Practice Address - Phone:423-910-0896
Practice Address - Fax:423-910-1183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP6522Medicare PIN
GACK6229Medicare PIN
TN3721254Medicare PIN