Provider Demographics
NPI:1043572837
Name:PREMIER WOMEN'S CARE
Entity Type:Organization
Organization Name:PREMIER WOMEN'S CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARUTHERS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:901-476-9311
Mailing Address - Street 1:1995 HIGHWAY 51 S
Mailing Address - Street 2:SUITE 112
Mailing Address - City:COVINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38019-3635
Mailing Address - Country:US
Mailing Address - Phone:901-476-9311
Mailing Address - Fax:901-476-8022
Practice Address - Street 1:1995 HIGHWAY 51 S
Practice Address - Street 2:SUITE 112
Practice Address - City:COVINGTON
Practice Address - State:TN
Practice Address - Zip Code:38019-3635
Practice Address - Country:US
Practice Address - Phone:901-476-9311
Practice Address - Fax:901-476-8022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-08
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN000029623207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty