Provider Demographics
NPI:1003247859
Name:LEGACY WOMEN'S HEALTHCARE, PC
Entity Type:Organization
Organization Name:LEGACY WOMEN'S HEALTHCARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KARYL
Authorized Official - Middle Name:
Authorized Official - Last Name:HONORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-983-2115
Mailing Address - Street 1:960 JOHNSON FY RD NE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1631
Mailing Address - Country:US
Mailing Address - Phone:404-583-1898
Mailing Address - Fax:
Practice Address - Street 1:960 JOHNSON FY RD NE
Practice Address - Street 2:SUITE 215
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1631
Practice Address - Country:US
Practice Address - Phone:404-583-1898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-04
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty