Provider Demographics
NPI:1578572632
Name:HENDERSON & WALTON WOMENS CENTER PC
Entity Type:Organization
Organization Name:HENDERSON & WALTON WOMENS CENTER PC
Other - Org Name:APG INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIR OF FINANCE ADMIN
Authorized Official - Prefix:MRS
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:CORNELIUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-930-1827
Mailing Address - Street 1:806 ST VINCENTS DRIVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205
Mailing Address - Country:US
Mailing Address - Phone:205-930-1800
Mailing Address - Fax:205-930-1817
Practice Address - Street 1:806 ST VINCENTS DRIVE
Practice Address - Street 2:SUITE 500
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205
Practice Address - Country:US
Practice Address - Phone:205-930-1800
Practice Address - Fax:205-930-1817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
51551071Medicare ID - Type UnspecifiedEDWARDS, JOHN
51506378Medicare ID - Type UnspecifiedHEATON, ALISON
C74832Medicare UPIN
51551077Medicare ID - Type UnspecifiedJONES, CYNTHIA
51551074Medicare ID - Type UnspecifiedLASSITER, CYNTHIA
51501728Medicare ID - Type UnspecifiedHUDSON, DAN
F02878Medicare UPIN
C74914Medicare UPIN
F16964Medicare UPIN
C74898Medicare UPIN
C74788Medicare UPIN
E78006Medicare UPIN
51514746Medicare ID - Type UnspecifiedINGRAM, KATHLEEN
H60060Medicare UPIN
51551078Medicare ID - Type UnspecifiedMOORE, ERNEST
AL102I167195Medicare PIN
H10094Medicare UPIN
51551081Medicare ID - Type UnspecifiedMCGRADY, GEORGE
51501742Medicare ID - Type UnspecifiedGUNNELLS, DREW
F79275Medicare UPIN
51551072Medicare ID - Type UnspecifiedHUDSON, CHARLES