John William Whitaker, DO
Family Medicine in Fort Defiance, AZ. Individual provider (NPI-1).
NPI number1730228917
StatusActive
Last updated in NPPESMay 5, 2022
Details
- NPI
- 1730228917
- Entity type
- Individual (NPI-1)
- Name
- John William Whitaker
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 5, 2007
- Certification date
- Apr 22, 2022
- Last updated
- May 5, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 2667871204 | UT | Yes |
| 207Q00000X | Family Medicine | DO1711 | NV | |
| 207Q00000X | Family Medicine | TL4235 | WY |
Practice location
Corner Of Route N12 And N7Fort Defiance, AZ 86504
Phone 928-729-8000
Mailing address
Po Box 649Fort Defiance, AZ 86504-0649
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All 24 Family Medicine Physician providers in Fort Defiance · All 627 providers in Fort Defiance
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