Healthcare Provider Details

I. General information

NPI: 1043486152
Provider Name (Legal Business Name): WYTHE PHYSICIANS FOR WOMEN, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2008
Last Update Date: 02/26/2020
Certification Date: 02/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 WEST MAIN STREET
WYTHEVILLE VA
24382
US

IV. Provider business mailing address

140 WEST MAIN STREET
WYTHEVILLE VA
24382
US

V. Phone/Fax

Practice location:
  • Phone: 276-228-2008
  • Fax: 276-228-5598
Mailing address:
  • Phone: 276-228-2008
  • Fax: 276-228-5598

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: DR. ELIZABETH A. FOX
Title or Position: MD/OWNER
Credential: MD
Phone: 276-228-2008