Provider Demographics
NPI:1174744379
Name:SOUTHERN WOMEN'S HEALTH, PLLC
Entity type:Organization
Organization Name:SOUTHERN WOMEN'S HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-932-5006
Mailing Address - Street 1:1020 RIVER OAKS DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9512
Mailing Address - Country:US
Mailing Address - Phone:601-932-5006
Mailing Address - Fax:601-932-4548
Practice Address - Street 1:1020 RIVER OAKS DR
Practice Address - Street 2:SUITE 310
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39232-9512
Practice Address - Country:US
Practice Address - Phone:601-932-5006
Practice Address - Fax:601-932-4548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty