Provider Demographics
NPI:1740215425
Name:WHIPPLE, JOHN RAYMOND (M D)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RAYMOND
Last Name:WHIPPLE
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4321 W 6TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-3607
Mailing Address - Country:US
Mailing Address - Phone:785-841-5555
Mailing Address - Fax:785-841-8781
Practice Address - Street 1:4321 W 6TH ST STE B
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-3607
Practice Address - Country:US
Practice Address - Phone:785-841-5555
Practice Address - Fax:785-841-8781
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-232232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS260049576OtherRAILROAD MEDICARE
KS260049576OtherRAILROAD MEDICARE
KS052683Medicare ID - Type Unspecified