Organization
THE WOMENS CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE H GORDON MD (CEO)
(678) 413-4644
Entity
Organization
Contact information
Practice address
2750 OWENS RD SW, SUITE A, CONYERS, GA 30094-3991
(678) 413-4644
(678) 413-4624
Mailing address
2750 OWENS RD SW, SUITE A, CONYERS, GA 30094-3991
(678) 413-4644
(678) 413-4624
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
049382
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DB5807
MEDICARE ID TYPE UNSPECIFIED
GA
Enumeration date
12/13/2006
Last updated
04/22/2008
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