MEDICARE: TREVOR W WHITMORE PA-C

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	363A00000X	Physician Assistant	2399	AZ

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	:	1649238783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TREVOR W WHITMORE PA-C

Provider Business Mailing Address
First Line	:	1425 S HIGLEY RD
Second Line	:	SUITE 102
City	:	GILBERT
State	:	AZ
Zip	:	85296-4798
Country	:	US
Telephone Number	:	480-988-6878
Fax Number	:	480-988-6879

Provider Business Practice Location Address
First Line	:	1425 S HIGLEY RD
Second Line	:	SUITE 102
City	:	GILBERT
State	:	AZ
Zip	:	85296-4798
Country	:	US
Telephone Number	:	480-988-6878
Fax Number	:	480-988-6879

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

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	01/11/2008

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Directions to “ TREVOR W WHITMORE PA-C” Practice Location

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