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General NPI Number Information
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NPI Number | 1174887236
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Entity Type | Organization
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Legal Business Name | WHITESBURG WOMEN'S CENTER, LLC
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Dates
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Enumeration Date | 07/03/2012
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Last Update Date | 07/03/2012
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Provider Practice Location Address
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Address Line | 214 HOSPITAL RD SUITE D
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City | WHITESBURG
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State | KY
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Zip | 41858-7627
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Country | US
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Telephone | 606-633-5553
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Fax |
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Provider Business Mailing Address
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Address Line | 214 HOSPITAL RD SUITE D
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City | WHITESBURG
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State | KY
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Zip | 41858-7627
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Country | US
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Telephone | 606-633-5553
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. NATHAN WADE BAKER
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Credential | M.D.
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Telephone | 606-633-5553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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