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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