Heritage Obstetrics & Gynecolgy Clinic Of Nm Pa

LBN: Heritage Obstetrics & Gynecolgy Clinic Of Nm Pa
Heritage Obstetrics & Gynecolgy Clinic Of Nm Pa is an health care organization with primary practice located at 606 Brunson Dr , Tupelo MS 38801-4947. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Heritage Obstetrics & Gynecolgy Clinic Of Nm Pa can be contacted via phone (662) 840-4010, or through Willis, Gregg A via phone (662) 840-4010.

Contact Information

Primary practice address
606 Brunson Dr Tupelo MS 38801-4947
Phone: (662) 840-4010
Fax: (662) 840-9038
Website:
Map and Directions
Authorized official contact:
Name: Willis, Gregg A Doctor of Medicine (MD)
Phone: (662) 840-4010

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 207V00000X Mississippi

Profile Details

NPI number 1407867807
LBN Legal business name Heritage Obstetrics & Gynecolgy Clinic Of Nm Pa
DBA Doing business as
Authorized official Willis, Gregg A Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 10th, 2006
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407867807 NPPES
Mississippi MEDICAID 05453772

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