Jerry David Whatley in Ardmore - Adolescent Medicine
Jerry David Whatley - NPI 1780634816
Jerry David Whatley is a Adolescent Medicine in Ardmore, Oklahoma. Jerry David Whatley practices all healthcare services and medical treatments related to Adolescent Medicine. The NPI Number for Jerry David Whatley is 1780634816. The last update date is 2011-01-07.
Jerry David Whatley's current location address is 936 Deese Rd, Ardmore, Oklahoma. You can contact this provider via phone number 5802249035. The mailing address for Jerry David Whatley is 936 Deese Rd, Ardmore, Oklahoma. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jerry David Whatley |
|---|---|
| Address | 936 Deese Rd, Ardmore, Oklahoma |
| Phone Number | 5802249035 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1780634816 |
|---|---|
| Provider Enumeration Date | 2006-05-11 |
| Last Updated Date | 2011-01-07 |
Provider Mailing Address Detail
| Address | 936 Deese Rd |
|---|---|
| City | Ardmore |
| State | Oklahoma (OK) |
| Post Code | 734019315 |
| Phone Number | 5802249035 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Adolescent Medicine |
|---|---|
| Taxonomy | 207Qa0000X |
| Licence No | 19096 |
|
Definition: A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 100114070G | OK | SOONERCARE MCD # | |
| 19096 | OK | OKLAHOMA LICENSE # | |
| 731612230 | OK | TAX ID # | |
| 100114070A | OK | -- |
Post Comment/ Review Below
What is the Jerry David Whatley's 1780634816?
The Jerry David Whatley's NPI (National Provider Identifier) Number is 1780634816. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Jerry David Whatley's facilities are situated?
The facilities of Jerry David Whatley are physically located at the following address: 936 Deese Rd, Ardmore, OK, 734019315.
What is Jerry David Whatley's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Jerry David Whatley's specialized field of practice is Adolescent Medicine, and the corresponding taxonomy code that categorizes this area of specialization is 207Qa0000X.
When was the Jerry David Whatley's 1780634816 issued?
The Jerry David Whatley's 1780634816 was issued on 2006-05-11.
When was the Jerry David Whatley's information last updated?
The Jerry David Whatley's information was last updated on 2011-01-07.