MEDICARE: DR. BRIAN THOMAS WHITFIELD D.C.

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	111N00000X	Chiropractor	676	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	35030	OTHER	MA	HPHC
2	Y35467	OTHER	MA	BCBS

General Provider Information

NPI Number	:	1063546604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN THOMAS WHITFIELD D.C.

Provider Business Mailing Address
First Line	:	26 NORTH ST
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-3311
Country	:	US
Telephone Number	:	508-747-2722
Fax Number	:	508-747-1499

Provider Business Practice Location Address
First Line	:	29 NORTH ST
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-8310
Country	:	US
Telephone Number	:	508-747-2722
Fax Number	:	508-747-1499

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

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	07/10/2012

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