MEDICARE: DR. GEORGE W. WHARTON M.D.

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	207XS0117X	Orthopaedic Surgery of the Spine Physician	F6344	TX
2	207X00000X	Orthopaedic Surgery Physician	F6344	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	883286	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730183765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE W. WHARTON M.D.

Provider Business Mailing Address
First Line	:	P.O. BOX 1322
Second Line	:
City	:	ADDISON
State	:	TX
Zip	:	75001-1322
Country	:	US
Telephone Number	:	972-991-9950
Fax Number	:	972-991-9548

Provider Business Practice Location Address
First Line	:	1341 W. MOCKINGBIRD LN
Second Line	:	MOCKINGBIRD TOWERS, SUITE 710E
City	:	DALLAS
State	:	TX
Zip	:	75247
Country	:	US
Telephone Number	:	214-217-7520
Fax Number	:	214-217-7530

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

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	10/01/2008

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Directions to “ DR. GEORGE W. WHARTON M.D.” Practice Location

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