Provider Demographics
NPI:1356608939
Name:WEBSTER ARTHRITIS CLINIC, PLLC
Entity type:Organization
Organization Name:WEBSTER ARTHRITIS CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELLA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WEBSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:571-234-7819
Mailing Address - Street 1:106 HIGHLAND WAY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-6929
Mailing Address - Country:US
Mailing Address - Phone:571-234-7819
Mailing Address - Fax:
Practice Address - Street 1:106 HIGHLAND WAY
Practice Address - Street 2:SUITE 202
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-6929
Practice Address - Country:US
Practice Address - Phone:571-234-7819
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS21566207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty