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WELLNESS FOR THE AGELESS WOMAN INC NPI 1144508896


NPI Information

NPI: 1144508896
Provider Name: WELLNESS FOR THE AGELESS WOMAN, INC
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization
Address:
4168 LOCH HIGHLAND PKWY NE
ROSWELL, GA
ZIP 30075
Phone: (770) 333-9405
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WELLNESS FOR THE AGELESS WOMAN, INC is an obstetrics gynecology in Roswell, GA. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. WELLNESS FOR THE AGELESS WOMAN, INC NPI is 1144508896. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4168 LOCH HIGHLAND PKWY NE
ROSWELL, GA
ZIP 30075-026
Phone: (770) 333-9405
Fax: (770) 333-9406

The provider's authorized official is Regina Bates .
The authorized official title is Practice Administrator and has the following contact phone number (770) 333-9405.

The enumeration date for this NPI number is 7/29/2011 and was last updated on 7/29/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207V00000XObstetrics & Gynecology033212GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000434805IMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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