Provider Demographics
NPI:1598726564
Name:WHIDDON, DAVID RICHMOND (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RICHMOND
Last Name:WHIDDON
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 1:430 MORTON PLANT ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3398
Mailing Address - Country:US
Mailing Address - Phone:727-461-6026
Mailing Address - Fax:727-461-7446
Practice Address - Street 1:430 MORTON PLANT ST
Practice Address - Street 2:SUITE 301
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3398
Practice Address - Country:US
Practice Address - Phone:727-461-6026
Practice Address - Fax:727-461-7446
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101102472207XS0114X
PAMD441209207XS0114X
FLME119574207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
I57499Medicare UPIN
PA416577OtherUPMC-WMG
MD971622OtherCAREFIRST BCBS-WMG
PA102545290Medicaid
PA039137900Medicaid
PAP01051459Medicare PIN
PA2571565OtherHIGHMARK BLUE SHIELD-WMG
I57499Medicare UPIN
PA1593954OtherGATEWAY-WMG
PA204249FLTMedicare PIN