Healthcare Provider Details

I. General information

NPI: 1710906599
Provider Name (Legal Business Name): LAURA K WHITNEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 S LIMESTONE
LEXINGTON KY
40536-0001
US

IV. Provider business mailing address

138 LEADER AVE
LEXINGTON KY
40508-3215
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-5481
  • Fax:
Mailing address:
  • Phone: 859-257-7910
  • Fax: 859-257-7899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number39487
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: