Organization
J. PHYLLIS WOMEN'S SPECIALTIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. J. PHYLLIS STEVENS (OWNER)
(812) 471-1122
Entity
Organization
Contact information
Practice address
2801 LINCOLN AVE, BLDG B, STE 2, EVANSVILLE, IN 47714-1751
(812) 471-1122
(812) 471-1133
Mailing address
2801 LINCOLN AVE, BLDG B, STE 2, EVANSVILLE, IN 47714-1751
(812) 471-1122
(812) 471-1133
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000290272
ANTHEM BC/BS
IN
Enumeration date
11/08/2005
Last updated
08/22/2020
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