Healthcare Provider Details

I. General information

NPI: 1588284442
Provider Name (Legal Business Name): KATHERINE BILLUPS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2020
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 12TH AVENUE
HUNTINGTON WV
25701-3833
US

IV. Provider business mailing address

1340 HAL GREER BLVD
HUNTINGTON WV
25701-3804
US

V. Phone/Fax

Practice location:
  • Phone: 304-522-3420
  • Fax: 304-529-4645
Mailing address:
  • Phone: 304-522-3420
  • Fax: 304-529-4645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number34068
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: