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NPI Code Detail

MEDICARE: ROBERT ALEXANDER WHISNANT JR. MD

MEDICARE:   ROBERT ALEXANDER WHISNANT JR. MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology Physician0101015139VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1010960OTHERVAANTHEM

General Provider Information

NPI Number : 1881638773
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT ALEXANDER WHISNANT JR. MD
Provider Business Mailing Address
First Line : 2108 LANGHORNE ROAD
Second Line :
City : LYNCHBURG
State : VA
Zip : 24501-1424
Country : US
Telephone Number : 434-845-2020
Fax Number : 434-845-2045
Provider Business Practice Location Address
First Line : 2108 LANGHORNE ROAD
Second Line :
City : LYNCHBURG
State : VA
Zip : 24501-1424
Country : US
Telephone Number : 434-845-2020
Fax Number : 434-845-2045
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 10/25/2007

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