Provider Demographics
NPI:1114156726
Name:WHITING, TREVOR KEITH (DPM)
Entity Type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:KEITH
Last Name:WHITING
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1465 KELLY JOHNSON BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3945
Mailing Address - Country:US
Mailing Address - Phone:719-488-4664
Mailing Address - Fax:719-488-4667
Practice Address - Street 1:1465 KELLY JOHNSON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3945
Practice Address - Country:US
Practice Address - Phone:719-488-4664
Practice Address - Fax:719-488-4667
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002330213ES0103X
WAOP60294170213ES0103X
COPOD.0000886213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery