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NPI Code Detail

MEDICARE: MARY JANE WHITSON MD

MEDICARE: MARY JANE WHITSON 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
1207P00000XEmergency Medicine Physician01087962AIN
2207P00000XEmergency Medicine Physician55799KY

General Provider Information

NPI Number : 1609304955
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY JANE WHITSON MD
Provider Business Mailing Address
First Line : PO BOX 18667
Second Line :
City : ERLANGER
State : KY
Zip : 41018-0667
Country : US
Telephone Number : 513-312-2247
Fax Number : 859-572-2326
Provider Business Practice Location Address
First Line : 85 N GRAND AVE
Second Line :
City : FORT THOMAS
State : KY
Zip : 41075-4027
Country : US
Telephone Number : 859-572-3618
Fax Number : 859-572-2326
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2017
Last Update Date : 11/17/2023

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Directions to “ MARY JANE WHITSON MD” Practice Location

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