Provider Demographics
NPI:1023141975
Name:WOMEN'S HEALTH CONSULTANTS OF THE OZARKS, LLC
Entity type:Organization
Organization Name:WOMEN'S HEALTH CONSULTANTS OF THE OZARKS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:PEYTON
Authorized Official - Last Name:HUBBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:573-348-6101
Mailing Address - Street 1:279 OAKMONT CT
Mailing Address - Street 2:
Mailing Address - City:LAKE OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65049-5741
Mailing Address - Country:US
Mailing Address - Phone:573-348-6101
Mailing Address - Fax:
Practice Address - Street 1:279 OAKMONT CT
Practice Address - Street 2:
Practice Address - City:LAKE OZARK
Practice Address - State:MO
Practice Address - Zip Code:65049-5741
Practice Address - Country:US
Practice Address - Phone:573-348-6101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR2P55174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOE86233Medicare UPIN