Provider Demographics
NPI:1629565072
Name:WOMENS CENTER FOR HEALTH AND WELLNESS, PLLC
Entity Type:Organization
Organization Name:WOMENS CENTER FOR HEALTH AND WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:REYNOLDS
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:479-431-7085
Mailing Address - Street 1:8101 MCCLURE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72916-6044
Mailing Address - Country:US
Mailing Address - Phone:479-459-6528
Mailing Address - Fax:479-222-6893
Practice Address - Street 1:8101 MCCLURE DR.
Practice Address - Street 2:SUITE 100
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72916
Practice Address - Country:US
Practice Address - Phone:479-431-7085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-20
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE5219207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty