Provider Demographics
NPI:1659326247
Name:WHITELEY, JAMES G JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:G
Last Name:WHITELEY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3 AUDUBON PLAZA DR
Mailing Address - Street 2:SUITE 450
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40217-1319
Mailing Address - Country:US
Mailing Address - Phone:502-636-0800
Mailing Address - Fax:502-636-0957
Practice Address - Street 1:3 AUDUBON PLAZA DR
Practice Address - Street 2:SUITE 450
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1319
Practice Address - Country:US
Practice Address - Phone:502-636-0800
Practice Address - Fax:502-636-0957
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY36800208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYH61906Medicare UPIN
KY0225211Medicare PIN