Provider Demographics
NPI:1508626359
Name:WOMEN'S SPECIALTY GROUP, PLLC
Entity Type:Organization
Organization Name:WOMEN'S SPECIALTY GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-553-3340
Mailing Address - Street 1:2900 MEDICAL CENTER PKWY STE 380
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-3214
Mailing Address - Country:US
Mailing Address - Phone:479-553-3340
Mailing Address - Fax:479-553-1964
Practice Address - Street 1:2900 MEDICAL CENTER PKWY STE 380
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3214
Practice Address - Country:US
Practice Address - Phone:479-553-3340
Practice Address - Fax:479-553-1964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty