Provider Demographics
NPI:1235143884
Name:CAMDEN WOMEN'S CENTER
Entity Type:Organization
Organization Name:CAMDEN WOMEN'S CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRANDON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-729-5563
Mailing Address - Street 1:1351 E. BOONE ST.
Mailing Address - Street 2:STE 21
Mailing Address - City:KINGSLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31548
Mailing Address - Country:US
Mailing Address - Phone:912-727-5563
Mailing Address - Fax:912-729-5564
Practice Address - Street 1:1351 EAST BOONE STREET
Practice Address - Street 2:SUITE 21
Practice Address - City:KINGSLAND
Practice Address - State:GA
Practice Address - Zip Code:31548
Practice Address - Country:US
Practice Address - Phone:912-727-5563
Practice Address - Fax:912-729-5564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA14890207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty