Provider Demographics
NPI:1598709263
Name:WOMENS HEALTH SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:WOMENS HEALTH SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:W
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-373-8949
Mailing Address - Street 1:PO BOX 372
Mailing Address - Street 2:DEPT 10
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38101-0372
Mailing Address - Country:US
Mailing Address - Phone:901-202-6120
Mailing Address - Fax:901-202-6117
Practice Address - Street 1:7800 WOLF TRAIL COVE
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138
Practice Address - Country:US
Practice Address - Phone:901-682-9222
Practice Address - Fax:901-682-9505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS07129753Medicaid
AR8P136OtherBCBS AR
DC3923OtherRAILROAD MEDICARE
TN3723253Medicaid
TN3723253Medicare PIN