Provider Demographics
NPI:1558773432
Name:ALTENS WOMENS HEALTH, LLC
Entity Type:Organization
Organization Name:ALTENS WOMENS HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:W
Authorized Official - Last Name:ALTEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-432-1050
Mailing Address - Street 1:65007 OLD 21 RD
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725
Mailing Address - Country:US
Mailing Address - Phone:740-432-1050
Mailing Address - Fax:740-432-1070
Practice Address - Street 1:65007 OLD 21 RD
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725
Practice Address - Country:US
Practice Address - Phone:740-432-1050
Practice Address - Fax:740-432-1070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35067443207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2027550Medicaid
OHG62619Medicare UPIN
OH2027550Medicaid