Provider Demographics
NPI:1679661631
Name:WHITTLE, KEVIN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:DAVID
Last Name:WHITTLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:300 N DAKOTA AVE
Mailing Address - Street 2:SUITE117
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-6037
Mailing Address - Country:US
Mailing Address - Phone:605-332-6800
Mailing Address - Fax:605-332-6826
Practice Address - Street 1:300 N DAKOTA AVE
Practice Address - Street 2:SUITE117
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-6037
Practice Address - Country:US
Practice Address - Phone:605-332-6800
Practice Address - Fax:605-332-6826
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD1667207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine