MEDICARE: JEFFREY C APPLEWHITE 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
1	208800000X	Urology Physician	L1263	TX

General Provider Information

NPI Number	:	1437145364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY C APPLEWHITE MD

Provider Business Mailing Address
First Line	:	5001 S COOPER ST STE 201
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-5993
Country	:	US
Telephone Number	:	866-367-8768
Fax Number	:	817-541-9555

Provider Business Practice Location Address
First Line	:	6801 OAKMONT BLVD STE 102
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-3903
Country	:	US
Telephone Number	:	866-367-8768
Fax Number	:	817-482-5380

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	12/17/2024

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