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NPI Code Detail

MEDICARE: JOHN TYLER WHITAKER DO

MEDICARE: JOHN TYLER WHITAKER DO
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 Physician5464OK
2208M00000XHospitalist Physician5464OK

General Provider Information

NPI Number : 1205195443
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN TYLER WHITAKER DO
Provider Business Mailing Address
First Line : 1705 E 19TH ST STE 302
Second Line :
City : TULSA
State : OK
Zip : 74104-5410
Country : US
Telephone Number : 918-748-7585
Fax Number : 918-403-6352
Provider Business Practice Location Address
First Line : 940 E 36TH ST N
Second Line :
City : TULSA
State : OK
Zip : 74106-1953
Country : US
Telephone Number : 918-398-9460
Fax Number : 918-992-2822
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2012
Last Update Date : 05/28/2026

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