Provider Demographics
NPI:1306854302
Name:WOMENS HEALTHCARE PC
Entity Type:Organization
Organization Name:WOMENS HEALTHCARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TOBY
Authorized Official - Middle Name:R
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:307-682-2233
Mailing Address - Street 1:1402 WEST 4TH STREET
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-3328
Mailing Address - Country:US
Mailing Address - Phone:307-682-2233
Mailing Address - Fax:307-682-2165
Practice Address - Street 1:1402 WEST 4TH STREET
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-3328
Practice Address - Country:US
Practice Address - Phone:307-682-2233
Practice Address - Fax:307-682-2233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY01241001OtherBLUE CROSS BLUE SHIELD
WY9931Medicare ID - Type Unspecified