Provider Demographics
NPI:1114027315
Name:WOMENS HEALTH CENTER PLLC
Entity Type:Organization
Organization Name:WOMENS HEALTH CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:HUBBS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-684-2300
Mailing Address - Street 1:1318 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:MCCOMB
Mailing Address - State:MS
Mailing Address - Zip Code:39648-2830
Mailing Address - Country:US
Mailing Address - Phone:601-684-2300
Mailing Address - Fax:601-684-2360
Practice Address - Street 1:1318 HARRISON AVE
Practice Address - Street 2:STE 500
Practice Address - City:MCCOMB
Practice Address - State:MS
Practice Address - Zip Code:39648-2830
Practice Address - Country:US
Practice Address - Phone:601-684-2300
Practice Address - Fax:601-684-2360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS434882043OtherBLUE CROSS BLUE SHIELD
MS438986798OtherBLUE CROSS BLUE SHIELD
MS08607OtherSTATE LICENSE
MS00115244Medicaid
LA1320960Medicaid
MS19007OtherSTATE LICENSE
MS17612OtherSTATE LICENSE
MS03402745Medicaid
MS03886877Medicaid
LA1043621Medicaid
LA1570591Medicaid
MS435250008OtherBLUE CROSS BLUE SHIELD
MS00126201Medicaid
LA1074489Medicaid
MS00126201Medicaid
LA1074489Medicaid
MSFT1769477OtherDEA
LA1043621Medicaid
MSBR7763027OtherDEA
MS08607OtherSTATE LICENSE
MSB30133Medicare UPIN
MS03886877Medicaid
MS00115244Medicaid