Provider Demographics
NPI:1275662355
Name:WOMENS CARE CENTER OF MEMPHIS,MPLLC DBA GYNECOLOGY & OBSTETRICS
Entity Type:Organization
Organization Name:WOMENS CARE CENTER OF MEMPHIS,MPLLC DBA GYNECOLOGY & OBSTETRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FLOY
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-762-4922
Mailing Address - Street 1:6215 HUMPHREYS BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2367
Mailing Address - Country:US
Mailing Address - Phone:901-767-3810
Mailing Address - Fax:901-763-3786
Practice Address - Street 1:7705 POPLAR AVE
Practice Address - Street 2:BLDG 'B' SUITE 220
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3930
Practice Address - Country:US
Practice Address - Phone:901-767-3810
Practice Address - Fax:901-763-3786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3714915Medicare ID - Type Unspecified