| Flavia H West Md | |
|
183 S Main St Pontotoc MS 38863-3209 | |
| (662) 489-5038 | |
| (662) 489-7004 |
| Full Name | Flavia H West Md |
|---|---|
| Speciality | Family Medicine |
| Location | 183 S Main St, Pontotoc, Mississippi |
| Authorized Official Name and Position | Flavia H West (OWNER) |
| Authorized Official Contact | 6624895038 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Flavia H West Md 183 S Main St Pontotoc MS 38863-3209 Ph: (662) 489-5038 | Flavia H West Md 183 S Main St Pontotoc MS 38863-3209 Ph: (662) 489-5038 |
| NPI Number | 1386982569 |
|---|---|
| Provider Enumeration Date | 01/23/2013 |
| Last Update Date | 01/23/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386982569 | NPI | - | NPPES |
| 00019567 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 10750 (Mississippi) | Primary |
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