Provider Demographics
NPI:1679877377
Name:COLEMAN, WHITNEY T (OD)
Entity Type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:T
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21913 W 95TH TER
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66220-9600
Mailing Address - Country:US
Mailing Address - Phone:785-224-8435
Mailing Address - Fax:
Practice Address - Street 1:10120 W 119TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-1600
Practice Address - Country:US
Practice Address - Phone:913-339-9090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-10
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010030908152W00000X
KS1866152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist