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NPI Code Detail

MEDICARE: DOCHELLE ANTOINETTE WHITLEY

MEDICARE:   DOCHELLE ANTOINETTE WHITLEY
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
1171M00000XCase Manager/Care CoordinatorOK

General Provider Information

NPI Number : 1518324391
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOCHELLE ANTOINETTE WHITLEY
Provider Business Mailing Address
First Line : 5309 FOSTER DR
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73135-1425
Country : US
Telephone Number : 405-474-4949
Fax Number :
Provider Business Practice Location Address
First Line : 5309 FOSTER DR
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73135-1425
Country : US
Telephone Number : 405-474-4949
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2016
Last Update Date : 01/25/2016

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Directions to “ DOCHELLE ANTOINETTE WHITLEY ” Practice Location

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