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NPI Code Detail

MEDICARE: JAMES A. WHITLOCK DO

MEDICARE: JAMES A. WHITLOCK 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
1207P00000XEmergency Medicine PhysicianE-4122AR

General Provider Information

NPI Number : 1295783322
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES A. WHITLOCK DO
Provider Business Mailing Address
First Line : PO BOX 217
Second Line :
City : BARDWELL
State : KY
Zip : 42023-0217
Country : US
Telephone Number : 800-893-9698
Fax Number :
Provider Business Practice Location Address
First Line : 900 W KINGSHIGHWAY
Second Line :
City : PARAGOULD
State : AR
Zip : 72450-5942
Country : US
Telephone Number : 800-893-9698
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 07/08/2007

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