MEDICARE: DR. JEANNETTE WHITNEY

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	2080N0001X	Neonatal-Perinatal Medicine Physician	J4611	TX

General Provider Information

NPI Number	:	1942266069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEANNETTE WHITNEY

Provider Business Mailing Address
First Line	:	3525 DOROTHY LN S
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-1731
Country	:	US
Telephone Number	:	817-763-0233
Fax Number	:	817-763-0233

Provider Business Practice Location Address
First Line	:	3525 DOROTHY LN S
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-1731
Country	:	US
Telephone Number	:	817-763-0233
Fax Number	:	817-763-0233

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	02/28/2008

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Directions to “ DR. JEANNETTE WHITNEY ” Practice Location

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