Provider Demographics
NPI:1437104056
Name:CENTER FOR WOMEN'S HEALTHCARE
Entity Type:Organization
Organization Name:CENTER FOR WOMEN'S HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CARLTON
Authorized Official - Last Name:NIX
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:256-533-8787
Mailing Address - Street 1:204 LOWE AVE SE STE 11
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4254
Mailing Address - Country:US
Mailing Address - Phone:256-533-8787
Mailing Address - Fax:256-533-8788
Practice Address - Street 1:204 LOWE AVE SE
Practice Address - Street 2:SUITE 11
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4262
Practice Address - Country:US
Practice Address - Phone:256-533-8787
Practice Address - Fax:256-533-8788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL23970174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009962665Medicaid
ALH40832Medicare UPIN
AL051522630Medicare ID - Type Unspecified