MEDICARE: HEATHER L. WHITESEL DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	SC005829	PA
2	213ES0103X	Foot & Ankle Surgery Podiatrist	E4735	CA
3	213ES0103X	Foot & Ankle Surgery Podiatrist	00357	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063492429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER L. WHITESEL DPM

Provider Business Mailing Address
First Line	:	740 S. LIMESTONE K-454
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40536-0284
Country	:	US
Telephone Number	:	859-323-1293
Fax Number	:	859-323-3823

Provider Business Practice Location Address
First Line	:	740 S. LIMESTONE K-454
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40536-0284
Country	:	US
Telephone Number	:	859-323-1293
Fax Number	:	916-683-7290

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	06/07/2011

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Directions to “ HEATHER L. WHITESEL DPM” Practice Location

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