Provider Demographics
NPI:1073683983
Name:WHITFIELD, JAMES HARVEY (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HARVEY
Last Name:WHITFIELD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1359
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087
Mailing Address - Country:US
Mailing Address - Phone:972-771-3668
Mailing Address - Fax:972-771-1878
Practice Address - Street 1:5939 HARRY HINES BLVD
Practice Address - Street 2:STE 325
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-6246
Practice Address - Country:US
Practice Address - Phone:214-879-6868
Practice Address - Fax:214-879-6871
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1562213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148585601Medicaid
TX00342PMedicare PIN
TX00449PMedicare PIN
TX148585601Medicaid