Provider Demographics
NPI:1265533350
Name:WOMANS PAVILION
Entity type:Organization
Organization Name:WOMANS PAVILION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CORTEZ
Authorized Official - Middle Name:EVON
Authorized Official - Last Name:MCFARLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-666-4294
Mailing Address - Street 1:1 ST VINCENT CR
Mailing Address - Street 2:#440
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5492
Mailing Address - Country:US
Mailing Address - Phone:501-666-4294
Mailing Address - Fax:501-666-8538
Practice Address - Street 1:1 ST VINCENT CR
Practice Address - Street 2:#440
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5492
Practice Address - Country:US
Practice Address - Phone:501-666-4294
Practice Address - Fax:501-666-8538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty