Provider Demographics
NPI:1629181219
Name:WOMEN'S CARE GROUP PC
Entity type:Organization
Organization Name:WOMEN'S CARE GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MD
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:B
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-544-6196
Mailing Address - Street 1:1932 ALCOA HWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1527
Mailing Address - Country:US
Mailing Address - Phone:865-544-6196
Mailing Address - Fax:865-544-6195
Practice Address - Street 1:1932 ALCOA HWY
Practice Address - Street 2:SUITE 150
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1527
Practice Address - Country:US
Practice Address - Phone:865-544-6196
Practice Address - Fax:865-544-6195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3776063Medicare ID - Type Unspecified
TN3776066Medicare ID - Type Unspecified
TN3776065Medicare ID - Type Unspecified