Healthcare Provider Details

I. General information

NPI: 1205121803
Provider Name (Legal Business Name): JORDAN WESLEY WHITSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2011
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 DUKE MEDICAL CIR
DURHAM NC
27710-3006
US

IV. Provider business mailing address

112 HANES HOUSE DUMC BOX 102351
DURHAM NC
27710-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-8111
  • Fax:
Mailing address:
  • Phone: 919-684-8111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number2017-01543
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: