Organization
WOMENS DIAGNOSTIC GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVELYN W. GAYDEN M.D. (CHIEF MANAGER)
(901) 226-0811
Entity
Organization
Contact information
Practice address
50 HUMPHREYS CENTER, SUITE 23, MEMPHIS, TN 38120-2373
(901) 383-1194
(901) 383-8985
Mailing address
PO BOX 1000, DEPT 34 WOMENS DIAGNOSTIC GROUP PLLC, MEMPHIS, TN 38120
(901) 383-1194
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04483898
—
MS
05
—
05675086
—
MS
05
—
07421890
—
MS
05
—
3377147
—
TN
01
—
4053282
BCBS
TN
01
—
8P034
BCBS
AR
Enumeration date
09/15/2006
Last updated
12/07/2020
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