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General NPI Number Information
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NPI Number | 1790713451
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Entity Type | Individual
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Provider Name | JOHN LEE WHITLOCK M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 01/14/2009
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Provider Practice Location Address
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Address Line | 136 FURMAN RD SUITE 7
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City | BOONE
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State | NC
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Zip | 28607-5038
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Country | US
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Telephone | 828-262-0060
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Fax | 828-262-0062
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Provider Business Mailing Address
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Address Line | 136 FURMAN RD SUITE 7
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City | BOONE
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State | NC
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Zip | 28607-5038
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Country | US
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Telephone | 828-262-0060
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Fax | 828-262-0062
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 28595
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | MD0000009984
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License Number State | TN
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