Whitehead, John R

Whitehead, John R is an individual health care provider with primary practice located at 2610 N Woodlawn Blvd , Wichita KS 67220-2729. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Whitehead, John R can be contacted via phone (316) 858-2610.

Contact Information

Primary practice address
2610 N Woodlawn Blvd Wichita KS 67220-2729
Fax: (316) 858-2793
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 05-20530 Kansas
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 05-20530 Kansas

Profile Details

NPI number 1265431860
LBN Legal business name Whitehead, John R
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2005
Last updated Dec 17th, 2010 - 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 1265431860 NPPES
Kansas Other P00615209 RR MEDICARE (PALMETTO)
Kansas MEDICAID 100229810I RR MEDICARE (PALMETTO)
Kansas MEDICAID 100229810J RR MEDICARE (PALMETTO)
Kansas MEDICAID 100229810R RR MEDICARE (PALMETTO)
Kansas MEDICAID 100229810Q RR MEDICARE (PALMETTO)

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