Provider Demographics
NPI:1346409851
Name:PITCHFORD, GENEVIEVE SMITH (DC)
Entity Type:Individual
Prefix:MRS
First Name:GENEVIEVE
Middle Name:SMITH
Last Name:PITCHFORD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 BLUE HERON BLVD
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-9716
Mailing Address - Country:US
Mailing Address - Phone:334-618-1227
Mailing Address - Fax:
Practice Address - Street 1:2900 GOVERNMENT ST STE B
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-5647
Practice Address - Country:US
Practice Address - Phone:228-215-1102
Practice Address - Fax:228-215-1103
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1203111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor