Basic Information
| Provider Information | |||||||||
| NPI: | 1962622571 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PIEDMONT HEALTHCARE FOR WOMEN, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | PHYSICIANS FOR WOMEN OF GREENSBORO, PA | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 802 GREEN VALLEY RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | GREENSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 274087041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3362733661 | ||||||||
| FaxNumber: | 3362739438 | ||||||||
| Practice Location | |||||||||
| Address1: | 802 GREEN VALLEY RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | GREENSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 274087041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3362733661 | ||||||||
| FaxNumber: | 3362739438 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2007 | ||||||||
| LastUpdateDate: | 08/15/2011 | ||||||||
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| AuthorizedOfficialLastName: | HICKS | ||||||||
| AuthorizedOfficialFirstName: | BETSY | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 3363872580 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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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 |
No ID Information.