Provider Demographics
NPI:1154585198
Name:WOMENS HEALTH SERVICES, CHATTANOOGA PC
Entity type:Organization
Organization Name:WOMENS HEALTH SERVICES, CHATTANOOGA PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:423-910-0896
Mailing Address - Street 1:935 SPRING CREEK RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37412-3994
Mailing Address - Country:US
Mailing Address - Phone:423-510-0250
Mailing Address - Fax:423-510-9524
Practice Address - Street 1:935 SPRING CREEK RD STE 100
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37412-3994
Practice Address - Country:US
Practice Address - Phone:423-510-0250
Practice Address - Fax:423-510-9524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD5026778207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3803684Medicaid
TNG31194OtherUPIN