Healthcare Provider Details

I. General information

NPI: 1902232994
Provider Name (Legal Business Name): WEST POINT OBGYN PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2013
Last Update Date: 04/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 MEDICAL CENTER DR
WEST POINT MS
39773-9318
US

IV. Provider business mailing address

735 MEDICAL CENTER DR
WEST POINT MS
39773-9318
US

V. Phone/Fax

Practice location:
  • Phone: 662-524-0884
  • Fax:
Mailing address:
  • Phone: 662-524-0884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY WHITTLE
Title or Position: OWNER
Credential: MD
Phone: 662-524-0884