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General NPI Number Information
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NPI Number | 1225162035
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Entity Type | Organization
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Legal Business Name | WHITTAKER AND TANG, P.A.
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 407 MAIN ST
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City | SENECA
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State | KS
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Zip | 66538-1925
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Country | US
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Telephone | 785-336-3571
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Fax |
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Provider Business Mailing Address
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Address Line | 407 MAIN ST
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City | SENECA
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State | KS
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Zip | 66538-1925
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Country | US
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Telephone | 785-336-3571
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DOUGLAS JAMES WHITTAKER
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Credential | O.D.
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Telephone | 785-336-3571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5793TG
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5788T
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1701
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1176-3
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License Number State | KS
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Taxonomy #5
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1700
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License Number State | KS
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