Healthcare Provider Details

I. General information

NPI: 1952310120
Provider Name (Legal Business Name): JAMES R WHIDDON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2006
Last Update Date: 01/24/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 E 29TH ST N #320
WICHITA KS
67226-2182
US

IV. Provider business mailing address

4900 S MONACO ST #210
DENVER CO
80237-3486
US

V. Phone/Fax

Practice location:
  • Phone: 316-858-7100
  • Fax: 316-858-7103
Mailing address:
  • Phone: 316-858-7100
  • Fax: 316-858-7103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number0427804
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: