Provider Demographics
NPI:1790072411
Name:HUSTON, WHITNEY LEIGH (DO)
Entity Type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:LEIGH
Last Name:HUSTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 EVES DR STE 300
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3135
Mailing Address - Country:US
Mailing Address - Phone:800-229-8183
Mailing Address - Fax:
Practice Address - Street 1:5 EVES DR
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3101
Practice Address - Country:US
Practice Address - Phone:856-596-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB09397400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine