Provider Demographics
NPI:1619900560
Name:ALL ABOUT WOMEN, OB-GYN, CHTD
Entity Type:Organization
Organization Name:ALL ABOUT WOMEN, OB-GYN, CHTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-785-1517
Mailing Address - Street 1:70 DOCTORS DR
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4517
Mailing Address - Country:US
Mailing Address - Phone:850-785-1517
Mailing Address - Fax:850-784-1271
Practice Address - Street 1:70 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4517
Practice Address - Country:US
Practice Address - Phone:850-785-1517
Practice Address - Fax:850-784-1271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAM241OtherBC/BS GROUP PROVIDER NUMBER
FLAM241Medicare PIN
FLAM241Medicare PIN