Individual
DR. JOHN EDWIN WITCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1488 HWY 487, SEBASTOPOL CLINIC, SEBASTOPOL, MS 39359
(601) 625-7403
(601) 625-7404
Mailing address
PO BOX 142, EAST CENTRAL MS HEALTH CARE INC, SEBASTOPOL, MS 39359
(601) 625-7140
(601) 625-7199
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
14977
MS
207Q00000X
Family Medicine Physician
14977
MS
208D00000X
General Practice Physician
14977
MS
208M00000X
Hospitalist Physician
14977
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126975
—
MS
Enumeration date
06/24/2006
Last updated
11/11/2019
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