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General NPI Number Information
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NPI Number | 1578533261
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Entity Type | Organization
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Legal Business Name | THORACIC & VASCULAR ASSOCIATES OF KINSTON PA
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 09/20/2012
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Provider Practice Location Address
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Address Line | 204 AIRPORT ROAD
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City | KINSTON
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State | NC
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Zip | 28504-8814
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Country | US
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Telephone | 252-939-9300
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Fax | 252-939-9305
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Provider Business Mailing Address
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Address Line | PO BOX 5485
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City | KINSTON
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State | NC
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Zip | 28503-5485
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Country | US
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Telephone | 252-939-9300
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Fax | 252-939-9305
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH D WHITLARK
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Credential | MD
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Telephone | 252-939-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number |
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License Number State |
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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