Provider Demographics
NPI:1104867324
Name:WHITFIELD, JOHN AARON (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:AARON
Last Name:WHITFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4124
Mailing Address - Country:US
Mailing Address - Phone:817-927-2229
Mailing Address - Fax:817-927-2334
Practice Address - Street 1:1250 8TH AVE
Practice Address - Street 2:SUITE 540
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4124
Practice Address - Country:US
Practice Address - Phone:817-927-2229
Practice Address - Fax:817-927-2334
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8505207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC23436Medicare UPIN