Provider Demographics
NPI:1467418103
Name:JAMIE, WHITNEY E (MD)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:E
Last Name:JAMIE
Suffix:
Gender:F
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:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-969-6552
Mailing Address - Fax:502-212-1358
Practice Address - Street 1:4121 DUTCHMANS LN
Practice Address - Street 2:SUITE 515
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4707
Practice Address - Country:US
Practice Address - Phone:502-899-6907
Practice Address - Fax:502-899-6905
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39226207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0305488OtherCIGNA / CMA DBA
KY64104227Medicaid
000000379510OtherANTHEM / CMA DBA
1223618OtherCHA / CMA DBA
50007178OtherPASSPORT / CMA DBA
000023031QOtherHUMANA / CMA DBA
IN200540690Medicaid
2448350000OtherPASSPORT ADVANTAGE / CMA DBA
061453OtherSIHO / CMA DBA
KYO50377Medicare UPIN
IN200540690Medicaid