Provider Demographics
NPI:1952310120
Name:WHIDDON, JAMES R (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:WHIDDON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:#210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:316-858-7100
Mailing Address - Fax:316-858-7103
Practice Address - Street 1:9300 E 29TH ST N
Practice Address - Street 2:#320
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2182
Practice Address - Country:US
Practice Address - Phone:316-858-7100
Practice Address - Fax:316-858-7103
Is Sole Proprietor?:No
Enumeration Date:2006-08-06
Last Update Date:2022-01-24
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Provider Licenses
StateLicense IDTaxonomies
KS0427804207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100389440AMedicaid
KS100389440EMedicaid
KS100389440AMedicaid
KS100389440EMedicaid
KSKA1908008Medicare PIN