Organization
FLAVIA H WEST MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FLAVIA H WEST MD (OWNER)
(662) 489-5038
Entity
Organization
Contact information
Practice address
183 S MAIN ST, PONTOTOC, MS 38863-3209
(662) 489-5038
(662) 489-7004
Mailing address
183 S MAIN ST, PONTOTOC, MS 38863-3209
(662) 489-5038
(662) 489-7004
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10750
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00019567
—
MS
Enumeration date
01/23/2013
Last updated
01/23/2013
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