Basic Information
| Provider Information | |||||||||
| NPI: | 1902890650 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TOTAL WOMAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4121 DUTCHMAN | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402074730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5028949494 | ||||||||
| FaxNumber: | 5028949404 | ||||||||
| Practice Location | |||||||||
| Address1: | 4121 DUTCHMAN'S LANE | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402074730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5028949494 | ||||||||
| FaxNumber: | 5028949404 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2005 | ||||||||
| LastUpdateDate: | 06/15/2010 | ||||||||
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| AuthorizedOfficialLastName: | ALSMAN | ||||||||
| AuthorizedOfficialFirstName: | EVELYN | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | CREDENTIAL/AUTORIZED OFFICIAN | ||||||||
| AuthorizedOfficialTelephone: | 5028949494 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VX0000X | KY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics |
No ID Information.