Provider Demographics
NPI:1497711006
Name:WHITMAN, RICHARD JAMES JR (MD)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:JAMES
Last Name:WHITMAN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RICHARD
Other - Middle Name:JAMES
Other - Last Name:WHITMAN
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:604 W WARNER RD
Mailing Address - Street 2:SUITE E 102
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225
Mailing Address - Country:US
Mailing Address - Phone:480-899-0060
Mailing Address - Fax:480-899-8026
Practice Address - Street 1:604 W WARNER RD
Practice Address - Street 2:SUITE E 102
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225
Practice Address - Country:US
Practice Address - Phone:480-899-0060
Practice Address - Fax:480-899-8026
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14188208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0180770OtherBCBS
AZ239013OtherAHCCCS
AZ239013OtherAHCCCS