Provider Demographics
NPI:1427210400
Name:WOMENS HEALTH SERVICES CHATTANOOGA PC
Entity Type:Organization
Organization Name:WOMENS HEALTH SERVICES CHATTANOOGA PC
Other - Org Name:UNIVERSITY WOMENS SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HERRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-756-4796
Mailing Address - Street 1:102 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-1503
Mailing Address - Country:US
Mailing Address - Phone:423-756-4796
Mailing Address - Fax:423-267-7117
Practice Address - Street 1:7794 RHEA COUNTY HWY
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TN
Practice Address - Zip Code:37321-5981
Practice Address - Country:US
Practice Address - Phone:423-756-4796
Practice Address - Fax:423-267-7117
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOMENS HEALTH SERVICES CHATTANOOGA PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-30
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3716357Medicare PIN