Provider Demographics
NPI:1801894720
Name:WOMEN'S HEALTH & MEDICAL SURGICAL SERVICES
Entity type:Organization
Organization Name:WOMEN'S HEALTH & MEDICAL SURGICAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:ADRIENNE
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-335-2080
Mailing Address - Street 1:545 N BUS US HWY 65
Mailing Address - Street 2:STE. 504
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-4500
Mailing Address - Country:US
Mailing Address - Phone:417-335-2080
Mailing Address - Fax:417-336-3583
Practice Address - Street 1:HC 6 BOX 11016
Practice Address - Street 2:EAST STATE HIGHWAY 76
Practice Address - City:BRANSON WEST
Practice Address - State:MO
Practice Address - Zip Code:65737-9806
Practice Address - Country:US
Practice Address - Phone:417-272-0505
Practice Address - Fax:417-272-3020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
26-3951Medicare ID - Type Unspecified