MEDICARE: DR. RICHARD WHITNEY 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	2084P0802X	Addiction Psychiatry Physician	35-079914	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1437157294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD WHITNEY MD

Provider Business Mailing Address
First Line	:	200 MESSIMER DR
Second Line	:
City	:	NEWARK
State	:	OH
Zip	:	43055-3627
Country	:	US
Telephone Number	:	220-564-4870
Fax Number	:	220-564-4871

Provider Business Practice Location Address
First Line	:	200 MESSIMER DR
Second Line	:
City	:	NEWARK
State	:	OH
Zip	:	43055-3627
Country	:	US
Telephone Number	:	220-564-4870
Fax Number	:	220-564-4871

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

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	02/20/2017

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