Individual
PATRICIA WEATHERSBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
202 W PARK AVE, GREENWOOD, MS 38930-3009
(662) 453-0646
(662) 455-6842
Mailing address
202 W PARK AVE, GREENWOOD, MS 38930-3009
(662) 453-0646
(662) 455-6842
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
08062
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00122953
—
MS
Enumeration date
10/12/2005
Last updated
07/08/2007
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