Individual
LOUISE GOMBAKO WITHERSPOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
777 LOWNDES HILL RD BLDG 1, GREENVILLE, SC 29607-2101
(864) 908-3530
(864) 967-2289
Mailing address
1015 APACHE DR, MCCOMB, MS 39648-6133
(601) 810-8889
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
19007
MS
207V00000X
Obstetrics & Gynecology Physician
MD61494933
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03886877
—
MS
01
—
1043621
LOUISIANA MEDICAID
LA
Enumeration date
09/25/2006
Last updated
09/24/2025
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