Provider Demographics
NPI:1093991903
Name:WHITEMAN, TAFFY J (OD)
Entity Type:Individual
Prefix:DR
First Name:TAFFY
Middle Name:J
Last Name:WHITEMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7155 SHERIDAN BLVD
Mailing Address - Street 2:DELIVER TO VISION CENTER
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80003-3803
Mailing Address - Country:US
Mailing Address - Phone:303-429-2020
Mailing Address - Fax:303-429-2020
Practice Address - Street 1:7155 SHERIDAN BLVD
Practice Address - Street 2:DELIVER TO VISION CENTER
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80003-3803
Practice Address - Country:US
Practice Address - Phone:303-429-2020
Practice Address - Fax:303-429-2020
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-10
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3250ATI152W00000X
CO2772152W00000X
FLOPC 4602152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL190HWOtherFLORIDA BLUE
FL007160900Medicaid
FLGS655ZMedicare PIN