Provider Demographics
NPI:1679669543
Name:BORTHWICK, PATRICIA ANN (DO)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:BORTHWICK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 E HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:SWEET SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:65351-2229
Mailing Address - Country:US
Mailing Address - Phone:660-335-4700
Mailing Address - Fax:
Practice Address - Street 1:105 E HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:SWEET SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:65351-2229
Practice Address - Country:US
Practice Address - Phone:660-335-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO118533207VG0400X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO244016804Medicaid
MO244016804Medicaid