Provider Demographics
NPI:1720151418
Name:WOMEN'S CARE CENTER OF MEMPHIS, MPLLC
Entity Type:Organization
Organization Name:WOMEN'S CARE CENTER OF MEMPHIS, MPLLC
Other - Org Name:DBA MID-SOUTH OB-GYN PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:GREENWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-747-1200
Mailing Address - Street 1:80 HUMPHREYS CTR
Mailing Address - Street 2:SUITE 330
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2353
Mailing Address - Country:US
Mailing Address - Phone:901-747-1200
Mailing Address - Fax:901-747-1220
Practice Address - Street 1:80 HUMPHREYS CTR
Practice Address - Street 2:SUITE 330
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2353
Practice Address - Country:US
Practice Address - Phone:901-747-1200
Practice Address - Fax:901-747-1220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3714914Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER