Provider Demographics
NPI:1831825819
Name:THE MIDWIFE CLINIC, LLC
Entity type:Organization
Organization Name:THE MIDWIFE CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWDY
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:706-528-4915
Mailing Address - Street 1:101 ELLIOTT DR NW STE E
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-1154
Mailing Address - Country:US
Mailing Address - Phone:706-528-4915
Mailing Address - Fax:706-584-7153
Practice Address - Street 1:101 ELLIOTT DR NW STE E
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-1154
Practice Address - Country:US
Practice Address - Phone:706-528-4915
Practice Address - Fax:706-584-7153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty