MEDICARE: JENNIFER LINDSAY WHITMORE D.O.

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	207R00000X	Internal Medicine Physician	0102203793	VA
2	207R00000X	Internal Medicine Physician	DO2579	NV

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
2	DO2579	OTHER	NV	STATE LICENSE
3	0102203793	OTHER	VA	VIRGINIA MEDICAL LICENSE

General Provider Information

NPI Number	:	1841566023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LINDSAY WHITMORE D.O.

Provider Business Mailing Address
First Line	:	6355 S BUFFALO DR FL 3
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-2133
Country	:	US
Telephone Number	:	702-216-3346
Fax Number	:	702-671-6883

Provider Business Practice Location Address
First Line	:	321 N NELLIS BLVD STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110-5416
Country	:	US
Telephone Number	:	702-438-4003
Fax Number	:	702-438-0555

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

Provider Enumeration Date	:	04/01/2012
Last Update Date	:	06/10/2024

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