Provider Demographics
NPI:1417167446
Name:WOMEN'S COMMUNITY CARE, PC
Entity type:Organization
Organization Name:WOMEN'S COMMUNITY CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:W
Authorized Official - Last Name:KILLEBREW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-991-2200
Mailing Address - Street 1:1279 HIGHWAY 54 W
Mailing Address - Street 2:SUITE 220
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-4550
Mailing Address - Country:US
Mailing Address - Phone:770-991-2200
Mailing Address - Fax:770-991-1341
Practice Address - Street 1:1279 HIGHWAY 54 W
Practice Address - Street 2:SUITE 220
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-4550
Practice Address - Country:US
Practice Address - Phone:770-991-2200
Practice Address - Fax:770-991-1341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty