Provider Demographics
NPI:1760641278
Name:ACADEMY OF WOMEN'S AND CHILDREN'S HEALTH, LLC
Entity Type:Organization
Organization Name:ACADEMY OF WOMEN'S AND CHILDREN'S HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-650-1332
Mailing Address - Street 1:2803 WRIGHTSBORO RD
Mailing Address - Street 2:SUITE 45
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-3913
Mailing Address - Country:US
Mailing Address - Phone:706-736-2737
Mailing Address - Fax:706-364-5808
Practice Address - Street 1:2803 WRIGHTSBORO RD
Practice Address - Street 2:SUITE 45
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-3913
Practice Address - Country:US
Practice Address - Phone:706-736-2737
Practice Address - Fax:706-364-5808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty