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NPI Code Detail

MEDICARE: DR. BARTLETT J WITHERSPOON JR. MD

MEDICARE: DR. BARTLETT J WITHERSPOON JR. MD
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
12085R0001XRadiation Oncology Physician72885WI
22085R0001XRadiation Oncology Physician7243SC

Other Identifiers

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

General Provider Information

NPI Number : 1295717973
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BARTLETT J WITHERSPOON JR. MD
Provider Business Mailing Address
First Line : PO BOX 2046
Second Line :
City : WEST COLUMBIA
State : SC
Zip : 29171-2046
Country : US
Telephone Number : 803-461-3000
Fax Number : 803-461-4914
Provider Business Practice Location Address
First Line : 515 22ND AVE
Second Line :
City : MONROE
State : WI
Zip : 53566-1569
Country : US
Telephone Number : 608-324-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2005
Last Update Date : 07/10/2023

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