Doctor Name: | DR. RICHARD WHALEN |
NPI Number: | 1346202983 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | MD26171 |
Business Practice Address: | 960 N 16th St Ste. 304 Springfield, OR - 974774175 |
Business Phone Number: | 5417467914 |
Business Fax Number: | |
Mailing Address: | 960 N 16th St, Ste. 304 SPRINGFIELD |
State: | OR |
Postal Code: | 974774175 |
Phone Number: | 5417467914 |
Fax Number: | |
NPI Enumeration Date: | 04/06/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | MD26171 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |