Organization
WOMENS CLINIC OF DYERSBURG, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY D WILSON (OFFICE MANAGER)
(731) 286-1319
Entity
Organization
Contact information
Practice address
305 E TICKLE ST, SUITE B, DYERSBURG, TN 38024-3117
(731) 286-1319
(731) 287-0420
Mailing address
1410 INDUSTRIAL PARK ROAD, PARIS, TN 38242
(800) 887-4359
(800) 555-0119
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC8704
RAILROAD MEDICARE
TN
Enumeration date
06/27/2006
Last updated
03/19/2013
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