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NPI Code Detail

MEDICARE: DR. JACOB WOODROW WHITENER JR. M.D.

MEDICARE: DR. JACOB WOODROW WHITENER JR. M.D.
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
12084P0800XPsychiatry Physician50853GA
22084P0800XPsychiatry Physician35230NC

General Provider Information

NPI Number : 1073538195
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACOB WOODROW WHITENER JR. M.D.
Provider Business Mailing Address
First Line : 327 1ST AVE NW
Second Line :
City : HICKORY
State : NC
Zip : 28601-6122
Country : US
Telephone Number : 828-695-5900
Fax Number : 828-695-4256
Provider Business Practice Location Address
First Line : 327 1ST AVE NW
Second Line :
City : HICKORY
State : NC
Zip : 28601-6122
Country : US
Telephone Number : 828-695-5900
Fax Number : 828-695-4256
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 10/24/2019

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