Basic Information
| Provider Information | |||||||||
| NPI: | 1336105493 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAPE CARE FOR WOMEN, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 150 S MOUNT AUBURN RD | ||||||||
| Address2: | SUITE 318 | ||||||||
| City: | CAPE GIRARDEAU | ||||||||
| State: | MO | ||||||||
| PostalCode: | 637034911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5733391166 | ||||||||
| FaxNumber: | 5733397166 | ||||||||
| Practice Location | |||||||||
| Address1: | 150 S MOUNT AUBURN RD | ||||||||
| Address2: | SUITE 318 | ||||||||
| City: | CAPE GIRARDEAU | ||||||||
| State: | MO | ||||||||
| PostalCode: | 637034910 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5733391166 | ||||||||
| FaxNumber: | 5733397166 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2006 | ||||||||
| LastUpdateDate: | 11/15/2007 | ||||||||
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| AuthorizedOfficialLastName: | WOOLARD | ||||||||
| AuthorizedOfficialFirstName: | DIANNE | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 5733391166 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | R2D86 | MO | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.