Basic Information
| Provider Information | |||||||||
| NPI: | 1174744379 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOUTHERN WOMEN'S HEALTH, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1020 RIVER OAKS DR | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | JACKSON | ||||||||
| State: | MS | ||||||||
| PostalCode: | 392329512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6019325006 | ||||||||
| FaxNumber: | 6019324548 | ||||||||
| Practice Location | |||||||||
| Address1: | 1020 RIVER OAKS DR | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | JACKSON | ||||||||
| State: | MS | ||||||||
| PostalCode: | 392329512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6019325006 | ||||||||
| FaxNumber: | 6019324548 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2007 | ||||||||
| LastUpdateDate: | 11/19/2011 | ||||||||
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| AuthorizedOfficialLastName: | ADAMS | ||||||||
| AuthorizedOfficialFirstName: | DAWN | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 6019325006 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VX0000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Obstetrics |
No ID Information.