Doctor Name: | DR. MICHAEL SHANE WHITLOCK |
NPI Number: | 1548295421 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | E3746 |
Business Practice Address: | 1503 Club Manor Dr Ste B Maumelle, AR - 721136089 |
Business Phone Number: | 5013719400 |
Business Fax Number: | 5019781473 |
Mailing Address: | 1503 Club Manor Dr Ste B, MAUMELLE |
State: | AR |
Postal Code: | 721136089 |
Phone Number: | 5013719400 |
Fax Number: | 5019781473 |
NPI Enumeration Date: | 07/11/2006 |
NPI Last Update Date: | 02/07/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | E3746 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |