Provider Demographics
NPI:1942238118
Name:WHITAKER, JAMES H (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:WHITAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:12639 OLD TESSON RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2786
Mailing Address - Country:US
Mailing Address - Phone:314-849-0311
Mailing Address - Fax:314-849-4423
Practice Address - Street 1:10701 NALL AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1231
Practice Address - Country:US
Practice Address - Phone:913-381-5225
Practice Address - Fax:913-341-3940
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2013-08-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS0419169207X00000X
MO33523207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO6033346OtherBATESCTY MEDICARE
MO04163037OtherBATESCTY BCBS
04163017OtherBCBS OTHER
MO201247418Medicaid
MOW053346OtherI-70 MEDCTR MEDICARE
04163017OtherBCBS KC
KS0447460003Medicare NSC
KSKA2451013Medicare PIN
04163017OtherBCBS OTHER
MO6033346OtherBATESCTY MEDICARE
MOW053346OtherI-70 MEDCTR MEDICARE