Provider Demographics
NPI:1811108558
Name:MT. PLEASANT CENTER FOR WOMEN'S HEALTH, PC
Entity type:Organization
Organization Name:MT. PLEASANT CENTER FOR WOMEN'S HEALTH, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:319-385-6765
Mailing Address - Street 1:407 S WHITE ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MT PLEASANT
Mailing Address - State:IA
Mailing Address - Zip Code:52641-2262
Mailing Address - Country:US
Mailing Address - Phone:319-385-6765
Mailing Address - Fax:319-385-6766
Practice Address - Street 1:407 S WHITE ST
Practice Address - Street 2:SUITE 104
Practice Address - City:MT PLEASANT
Practice Address - State:IA
Practice Address - Zip Code:52641-2262
Practice Address - Country:US
Practice Address - Phone:319-385-6765
Practice Address - Fax:319-385-6766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA35834207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0456160Medicaid
IA1962515890OtherINDIVIDUAL NPI - TYPE 1
IA1962515890OtherINDIVIDUAL NPI - TYPE 1
IAI14418Medicare PIN