Healthcare Provider Details

I. General information

NPI: 1679669543
Provider Name (Legal Business Name): PATRICIA ANN BORTHWICK D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 03/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 E HOSPITAL DR
SWEET SPRINGS MO
65351-2229
US

IV. Provider business mailing address

105 E HOSPITAL DR
SWEET SPRINGS MO
65351-2229
US

V. Phone/Fax

Practice location:
  • Phone: 660-335-4700
  • Fax:
Mailing address:
  • Phone: 660-335-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number118533
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number118533
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: