Provider Demographics
NPI:1457575458
Name:WOMAN'S CLINIC, P.A.
Entity Type:Organization
Organization Name:WOMAN'S CLINIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:LEHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:228-864-2752
Mailing Address - Street 1:4577 13TH ST
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39501-2516
Mailing Address - Country:US
Mailing Address - Phone:228-864-2752
Mailing Address - Fax:228-214-4206
Practice Address - Street 1:4577 13TH ST
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-2516
Practice Address - Country:US
Practice Address - Phone:228-864-2752
Practice Address - Fax:228-214-4206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00013996Medicaid
MS00013996Medicaid