Healthcare Provider Details

I. General information

NPI: 1821098229
Provider Name (Legal Business Name): DUANE M WHITLOCK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 07/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 S WASHINGTON ST SUITE 24
GETTYSBURG PA
17325-2516
US

IV. Provider business mailing address

455 S WASHINGTON ST SUITE 24
GETTYSBURG PA
17325-2516
US

V. Phone/Fax

Practice location:
  • Phone: 717-334-9159
  • Fax: 334-359-7225
Mailing address:
  • Phone: 717-334-9159
  • Fax: 334-359-7225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD418674
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: