Provider Demographics
NPI:1003868779
Name:HANDES OF A WOMAN
Entity Type:Organization
Organization Name:HANDES OF A WOMAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-298-5333
Mailing Address - Street 1:PO BOX 176
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36037-0176
Mailing Address - Country:US
Mailing Address - Phone:334-335-2095
Mailing Address - Fax:334-335-2279
Practice Address - Street 1:58 ROY BEALL DR
Practice Address - Street 2:
Practice Address - City:LUVERNE
Practice Address - State:AL
Practice Address - Zip Code:36049-6800
Practice Address - Country:US
Practice Address - Phone:334-335-2095
Practice Address - Fax:334-335-2279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK51002757OtherBC BS OF ALABAMA
OHG30061Medicare UPIN