Basic Information
| Provider Information | |||||||||
| NPI: | 1760965982 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WOMEN'S CARE GROUP PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 306359 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372306359 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8656706199 | ||||||||
| FaxNumber: | 8656706198 | ||||||||
| Practice Location | |||||||||
| Address1: | 270 BMH PHYSICIAN OFFICE BUILDING | ||||||||
| Address2: | PHYSICIANS OFFICE BUILDING | ||||||||
| City: | MARYVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 378043780 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8655461642 | ||||||||
| FaxNumber: | 8656817949 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2018 | ||||||||
| LastUpdateDate: | 11/26/2019 | ||||||||
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| AuthorizedOfficialLastName: | TURNER | ||||||||
| AuthorizedOfficialFirstName: | JULIE | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8655461642 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | Q044524 | 05 | TN | MEDICAID |