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NPI Code Detail

MEDICARE: DR. HEATHER SAMMONS WHITWORTH MD

MEDICARE: DR. HEATHER SAMMONS WHITWORTH 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
1174400000XSpecialistME0072535FL
2208D00000XGeneral Practice PhysicianME72535FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922119601
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HEATHER SAMMONS WHITWORTH MD
Provider Business Mailing Address
First Line : PO BOX 191
Second Line : PROVIDER ENROLLMENT DEPARTMENT
City : ROCKLAND
State : DE
Zip : 19732-0191
Country : US
Telephone Number : 302-651-4488
Fax Number : 302-651-4945
Provider Business Practice Location Address
First Line : 435 2ND ST NE
Second Line : NEMOURS CHILDRENS PRIMARY CARE, KINDER CLINIC
City : WINTER HAVEN
State : FL
Zip : 33881-4103
Country : US
Telephone Number : 863-299-4567
Fax Number : 863-297-9750
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 12/05/2014

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