Provider Demographics
NPI:1528005592
Name:WHELCHEL, JEFFERY T (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:T
Last Name:WHELCHEL
Suffix:
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 1:4514 CORNELL ST STE B
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-5801
Mailing Address - Country:US
Mailing Address - Phone:806-350-7807
Mailing Address - Fax:806-350-7546
Practice Address - Street 1:4514 CORNELL ST STE B
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-5801
Practice Address - Country:US
Practice Address - Phone:806-350-7807
Practice Address - Fax:806-350-7546
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8833207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX353884501Medicaid
TX5974502OtherAETNA
TX874032OtherBCBS
874032Medicare ID - Type Unspecified