Provider Demographics
NPI:1255541520
Name:WOMAN'S CENTER FOR ADVANCED PELVIC SURGERY PLLP
Entity type:Organization
Organization Name:WOMAN'S CENTER FOR ADVANCED PELVIC SURGERY PLLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STRATFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-834-5111
Mailing Address - Street 1:P.O. BOX 12127
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4012
Mailing Address - Country:US
Mailing Address - Phone:480-834-5111
Mailing Address - Fax:480-834-5222
Practice Address - Street 1:4344 E PRESIDIO ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85215-1134
Practice Address - Country:US
Practice Address - Phone:480-834-5111
Practice Address - Fax:480-834-5222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic SurgeryGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty