Whitaker, John C

Whitaker, John C is an sole proprietor health care provider with primary practice located at 2713 S 74Th St Suite 408, Fort Smith AR 72903-5170. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Whitaker, John C can be contacted via phone (479) 484-5646.

Contact Information

Primary practice address
2713 S 74Th St Suite 408 Fort Smith AR 72903-5170
Fax: (479) 242-2323
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X C-7165 Arkansas

Profile Details

NPI number 1467461764
LBN Legal business name Whitaker, John C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 5th, 2006
Last updated Apr 15th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467461764 NPPES
Arkansas MEDICAID 115671001

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