Provider Demographics
NPI:1679861314
Name:WOMENS CARE OF SOMERSET CORP
Entity Type:Organization
Organization Name:WOMENS CARE OF SOMERSET CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TARA
Authorized Official - Middle Name:R
Authorized Official - Last Name:HORN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-451-3145
Mailing Address - Street 1:402 BOGLE ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-2870
Mailing Address - Country:US
Mailing Address - Phone:606-451-3145
Mailing Address - Fax:606-451-3149
Practice Address - Street 1:402 BOGLE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2870
Practice Address - Country:US
Practice Address - Phone:606-451-3145
Practice Address - Fax:606-451-3149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-15
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK025061Medicare UPIN