=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558495812
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WOODS CHAPEL MEDICAL GROUP PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/16/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1523 SW 7 HWY
-----------------------------------------------------
City | BLUE SPRINGS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64015
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-229-5600
-----------------------------------------------------
Fax | 816-229-0181
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1523 SW 7 HWY
-----------------------------------------------------
City | BLUE SPRINGS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64015
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-229-5600
-----------------------------------------------------
Fax | 816-229-0181
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | DR. WILLIAM E WHITLEY
-----------------------------------------------------
Credential | D.O.
-----------------------------------------------------
Telephone | 816-229-5600
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 32382
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------