MEDICARE: JOSEPH P WHITLOCK 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	207R00000X	Internal Medicine Physician	TRAINING	FL
2	2085R0202X	Diagnostic Radiology Physician	077990	GA
3	2085R0202X	Diagnostic Radiology Physician	0101288032	VA

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	:	1891089272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH P WHITLOCK M.D.

Provider Business Mailing Address
First Line	:	4500 SAN PABLO RD S
Second Line	:	PROVIDER ENROLLMENT
City	:	JACKSONVILLE
State	:	FL
Zip	:	32224-1865
Country	:	US
Telephone Number	:	904-953-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 W ACADEMY STREET
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30501
Country	:	US
Telephone Number	:	770-282-8820
Fax Number	:

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

Provider Enumeration Date	:	06/03/2011
Last Update Date	:	01/27/2026

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