Provider Demographics
NPI:1467504274
Name:WOMENS PELVIC HEALTH AND CONTINENCE CENTER
Entity type:Organization
Organization Name:WOMENS PELVIC HEALTH AND CONTINENCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER,PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-333-6161
Mailing Address - Street 1:6440 W NEWBERRY RD
Mailing Address - Street 2:SUITE 409
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4381
Mailing Address - Country:US
Mailing Address - Phone:352-333-6161
Mailing Address - Fax:352-333-6162
Practice Address - Street 1:6440 W NEWBERRY RD
Practice Address - Street 2:SUITE 409
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4381
Practice Address - Country:US
Practice Address - Phone:352-333-6161
Practice Address - Fax:352-333-6162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00299892OtherMEDICARE RAILROAD
FLP00299892OtherMEDICARE RAILROAD