Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 11141 | GA |
NPI | 1114247996 |
---|---|
Provider Name | John Heath West |
First Address | Savannah, GA 31406-3224 |
Second Address | Savannah, GA 31406-3224 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2010 |
Last Update Date | 03/06/2010 |