Doctor Name: | MR. JAMES MICHAEL WHITTINGTON |
NPI Number: | 1215323886 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | NP |
License Number: | AP08195 |
Business Practice Address: | 530 W Pine St Suite 1 Ponchatoula, LA - 704543780 |
Business Phone Number: | 9855074655 |
Business Fax Number: | |
Mailing Address: | Po Box 2274, HAMMOND |
State: | LA |
Postal Code: | 704042274 |
Phone Number: | 9855074655 |
Fax Number: | |
NPI Enumeration Date: | 04/10/2015 |
NPI Last Update Date: | 01/13/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP08195 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |