Provider Demographics
NPI:1992846786
Name:WOMEN'S HEALTH PARTNERS OF EAST TENNESSEE PC
Entity Type:Organization
Organization Name:WOMEN'S HEALTH PARTNERS OF EAST TENNESSEE PC
Other - Org Name:WOMEN'S HEALTH ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:COLLIER
Authorized Official - Last Name:CRABTREE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-481-0200
Mailing Address - Street 1:200 NEW YORK AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-5227
Mailing Address - Country:US
Mailing Address - Phone:865-481-0200
Mailing Address - Fax:865-481-3085
Practice Address - Street 1:9330 PARK WEST BLVD STE 300
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4311
Practice Address - Country:US
Practice Address - Phone:865-531-1400
Practice Address - Fax:865-690-9750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN007939207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3714760Medicaid
TN3714760Medicaid