Provider Demographics
NPI:1689677411
Name:WHITESELL, WILLIAM LEE (OD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LEE
Last Name:WHITESELL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:21900 S WEBSTER ST
Mailing Address - Street 2:STE B
Mailing Address - City:SPRING HILL
Mailing Address - State:KS
Mailing Address - Zip Code:66083-9609
Mailing Address - Country:US
Mailing Address - Phone:913-592-2020
Mailing Address - Fax:913-592-5232
Practice Address - Street 1:21900 S WEBSTER ST
Practice Address - Street 2:STE B
Practice Address - City:SPRING HILL
Practice Address - State:KS
Practice Address - Zip Code:66083-9609
Practice Address - Country:US
Practice Address - Phone:913-592-2020
Practice Address - Fax:913-273-0528
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1315152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS260043246OtherTRI WEST
KS100644720AMedicaid
KS16922066OtherBCBS OF KANSAS CITY
KS650967OtherBCBS OF KANSAS
KS410049909OtherRAILROAD MEDICARE
KS410049909OtherRAILROAD MEDICARE