Provider Demographics
NPI:1891751467
Name:RICHARD J WHITMAN JR MD
Entity Type:Organization
Organization Name:RICHARD J WHITMAN JR MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL SURGERY
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:WHITMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:480-899-0060
Mailing Address - Street 1:604 W WARNER RD
Mailing Address - Street 2:SUITE E-102
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225
Mailing Address - Country:US
Mailing Address - Phone:480-899-0060
Mailing Address - Fax:480-899-8026
Practice Address - Street 1:604 W WARNER RD
Practice Address - Street 2:SUITE E-102
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225
Practice Address - Country:US
Practice Address - Phone:480-899-0060
Practice Address - Fax:480-899-8026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14188208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0180770OtherBCBS
AZ239013OtherAHCCCS
AZAZ0180770OtherBCBS