Provider Demographics
NPI:1487696837
Name:WOMEN'S HEALTHCARE OF MIDDLE GA, INC
Entity type:Organization
Organization Name:WOMEN'S HEALTHCARE OF MIDDLE GA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:HALL
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-922-9136
Mailing Address - Street 1:130 BYRD WAY
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-8937
Mailing Address - Country:US
Mailing Address - Phone:478-922-9136
Mailing Address - Fax:478-923-6846
Practice Address - Street 1:130 BYRD WAY
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-8937
Practice Address - Country:US
Practice Address - Phone:478-922-9136
Practice Address - Fax:478-923-6846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA046017207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GRP865Medicare ID - Type Unspecified