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Organization
GREGORY P. WITTPENN, MD PA
Active
Organization
GREGORY P. WITTPENN, MD PA
Active
Other names
New Horizons Plastic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY PAUL WITTPENN (PHYSICIAN)
(936) 564-3744
Entity
Organization
Contact information
Practice address
3616 N UNIVERSITY DR, NACOGDOCHES, TX 75965-2539
(936) 564-3744
Mailing address
3616 N UNIVERSITY DR, NACOGDOCHES, TX 75965-2539
(936) 564-3744
Taxonomy
Speciality
Code
Description
License number
State
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007OLY
BLUE CROSS BLUE SHIELD
TX
05
—
173182001
—
TX
Enumeration date
01/08/2008
Last updated
01/30/2020
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