| Organization Name: | WILLIAMSBURG REGIONAL HOSPITAL |
| NPI Number: | 1265866172 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUANITA JEFFERSON (PRACTICE MANAGER) |
| Mailing Address: | 402 Nelson Blvd Suite 100 Kingstree |
| State: | SC US |
| Postal Code: | 29556 |
| Phone Number: | 8433550201 |
| Fax Number: | 8433550123 |
| NPI Enumeration Date: | 08/27/2013 |
| NPI Last Update Date: | 09/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VX0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Obstetrics |
| Taxonomy Definition: | |