Basic Information
| Provider Information | |||||||||
| NPI: | 1841289915 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WOMEN'S HEALTH CENTER, PROFESSIONAL ASSOCIATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 309 | ||||||||
| Address2: | |||||||||
| City: | EL DORADO | ||||||||
| State: | KS | ||||||||
| PostalCode: | 670420309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3163228500 | ||||||||
| FaxNumber: | 3163227750 | ||||||||
| Practice Location | |||||||||
| Address1: | 700 W CENTRAL AVE | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | EL DORADO | ||||||||
| State: | KS | ||||||||
| PostalCode: | 670422184 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3163228500 | ||||||||
| FaxNumber: | 3163227750 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2005 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | RODRIGUEZ | ||||||||
| AuthorizedOfficialFirstName: | SUZETTE | ||||||||
| AuthorizedOfficialMiddleName: | MARIE | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3163228500 | ||||||||
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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 | 28212 | KS | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.