Provider Demographics
NPI:1013034032
Name:WHITMAN, JASON B (OD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:B
Last Name:WHITMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4621 SW WYOMING BLVD
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-6702
Mailing Address - Country:US
Mailing Address - Phone:307-439-0100
Mailing Address - Fax:307-439-1062
Practice Address - Street 1:4621 SW WYOMING BLVD
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-6702
Practice Address - Country:US
Practice Address - Phone:307-439-0100
Practice Address - Fax:307-439-1062
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY282T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYU93934Medicare UPIN