Provider Demographics
NPI:1306957030
Name:WOMENS HEALTH ASSOCIATION OF TITUSVILLE
Entity type:Organization
Organization Name:WOMENS HEALTH ASSOCIATION OF TITUSVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:RUTHELLEN
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:WEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-827-7229
Mailing Address - Street 1:602 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16354-2152
Mailing Address - Country:US
Mailing Address - Phone:814-827-7229
Mailing Address - Fax:814-827-4869
Practice Address - Street 1:602 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16354-2152
Practice Address - Country:US
Practice Address - Phone:814-827-7229
Practice Address - Fax:814-827-4869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA029120E207V00000X
PA044541L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000276090OtherHIGHMARK
PAW0276090OtherBCBS
PA=========OtherHEALTH AMERICA
PA028828NEJMedicare ID - Type Unspecified