Provider Demographics
NPI:1346358991
Name:WHITMORE, ROBERT LESTER II (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:LESTER
Last Name:WHITMORE
Suffix:II
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 1:715 W MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:STORM LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:50588-1564
Mailing Address - Country:US
Mailing Address - Phone:712-213-0109
Mailing Address - Fax:712-213-0186
Practice Address - Street 1:715 W MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:STORM LAKE
Practice Address - State:IA
Practice Address - Zip Code:50588-1564
Practice Address - Country:US
Practice Address - Phone:712-213-0109
Practice Address - Fax:712-213-0186
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA38150207Q00000X, 207Q00000X
SCLL27990207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine