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NPI Code Detail

MEDICARE: DR. KEYNA JURI WHITNEY M.D.

MEDICARE: DR. KEYNA JURI WHITNEY 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
1207Q00000XFamily Medicine Physician200566LA

Other Identifiers

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

General Provider Information

NPI Number : 1164454088
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEYNA JURI WHITNEY M.D.
Provider Business Mailing Address
First Line : 13675 COURSEY BLVD
Second Line : APT. 1525
City : BATON ROUGE
State : LA
Zip : 70817-1344
Country : US
Telephone Number : 225-751-8165
Fax Number :
Provider Business Practice Location Address
First Line : 73153 MILITARY RD
Second Line :
City : COVINGTON
State : LA
Zip : 70435-6054
Country : US
Telephone Number : 985-626-6133
Fax Number : 985-626-6136
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 07/08/2007

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