Provider Demographics
NPI:1205028586
Name:GENTLE GYNECOLOGY P.C.
Entity Type:Organization
Organization Name:GENTLE GYNECOLOGY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LILLIAN
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:ALDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-792-2121
Mailing Address - Street 1:1500 A HWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-7129
Mailing Address - Country:US
Mailing Address - Phone:816-792-2121
Mailing Address - Fax:816-792-3291
Practice Address - Street 1:1500 A HWY
Practice Address - Street 2:SUITE C
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-7129
Practice Address - Country:US
Practice Address - Phone:816-792-2121
Practice Address - Fax:816-792-3291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR6H78207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C51495Medicare UPIN