Provider Demographics
NPI:1629182019
Name:SHERIDAN WOMEN'S HEALTH P.C.
Entity Type:Organization
Organization Name:SHERIDAN WOMEN'S HEALTH P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:G
Authorized Official - Last Name:GILL
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:307-672-2522
Mailing Address - Street 1:1333 W 5TH ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-2751
Mailing Address - Country:US
Mailing Address - Phone:307-672-2522
Mailing Address - Fax:307-672-3732
Practice Address - Street 1:1333 W 5TH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-2751
Practice Address - Country:US
Practice Address - Phone:307-672-2522
Practice Address - Fax:307-672-3732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty