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General NPI Number Information
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NPI Number | 1255437588
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Entity Type | Individual
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Provider Name | TIMOTHY SEAN WHITAKER MD
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Gender | Male
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 04/08/2024
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Provider Practice Location Address
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Address Line | 449 MAIN ST
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City | ONEONTA
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State | NY
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Zip | 13820-2028
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Country | US
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Telephone | 607-432-5680
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Fax | 607-432-5575
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Provider Business Mailing Address
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Address Line | PO BOX 100707
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City | ATLANTA
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State | GA
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Zip | 30384-0707
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Country | US
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Telephone | 786-594-6880
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME161759
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 218885
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License Number State | NY
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