Healthcare Provider Details

I. General information

NPI: 1275707903
Provider Name (Legal Business Name): ROBERT HUGH WHITTINGTON LPTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2008
Last Update Date: 04/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 GREENSBORO RD
HIGH POINT NC
27260-2611
US

IV. Provider business mailing address

811 BELMONT DR 1-C
HIGH POINT NC
27263-2376
US

V. Phone/Fax

Practice location:
  • Phone: 336-821-6592
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number1715
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1715
Identifier TypeOTHER
Identifier StateNC
Identifier IssuerLPTA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: