Provider Demographics
NPI:1437424942
Name:WHITTON, JONATHAN LEWIS
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:LEWIS
Last Name:WHITTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAYRE
Mailing Address - State:OK
Mailing Address - Zip Code:73662-1907
Mailing Address - Country:US
Mailing Address - Phone:405-268-8090
Mailing Address - Fax:
Practice Address - Street 1:501 E GRAND AVE
Practice Address - Street 2:
Practice Address - City:SAYRE
Practice Address - State:OK
Practice Address - Zip Code:73662-1907
Practice Address - Country:US
Practice Address - Phone:405-268-8090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-16
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)