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General NPI Number Information
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NPI Number | 1063404002
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Entity Type | Individual
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Provider Name | THOMAS L WHITTAKER MD
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Gender | Male
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Dates
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Enumeration Date | 08/16/2005
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Last Update Date | 08/10/2012
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Provider Practice Location Address
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Address Line | ONE MEMORIAL SQ STE 50
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City | GREENFIELD
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State | IN
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Zip | 46140-1357
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Country | US
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Telephone | 317-467-7100
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Fax | 317-467-0209
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Provider Business Mailing Address
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Address Line | 6330 E 75TH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-2777
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Country | US
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Telephone | 317-594-6900
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Fax | 317-594-6911
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 01041624
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207RH0000X
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Taxonomy Name | Hematology (Internal Medicine) Physician
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License Number | 01041624
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License Number State | IN
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