Healthcare Provider Details

I. General information

NPI: 1437148111
Provider Name (Legal Business Name): WILLIAM F WHITEFORD PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 03/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 E SPRINGBROOK RD
BROADWAY VA
22815-9526
US

IV. Provider business mailing address

171 E SPRINGBROOK RD
BROADWAY VA
22815-9526
US

V. Phone/Fax

Practice location:
  • Phone: 540-901-9501
  • Fax: 540-901-8773
Mailing address:
  • Phone: 540-901-9501
  • Fax: 540-901-8773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number2305002895
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: