Provider Demographics
NPI:1245201813
Name:WHITELAW, STEVEN W (DC, CCSP)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:W
Last Name:WHITELAW
Suffix:
Gender:M
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1523
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72702-1523
Mailing Address - Country:US
Mailing Address - Phone:479-571-6038
Mailing Address - Fax:479-582-0222
Practice Address - Street 1:2744 E MILLENNIUM PL
Practice Address - Street 2:SUITE 1
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4798
Practice Address - Country:US
Practice Address - Phone:479-571-8400
Practice Address - Fax:479-571-8401
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1475111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5T667Medicare ID - Type Unspecified
ARU67851Medicare UPIN