Provider Demographics
NPI:1982637708
Name:WHITNEY, JONATHAN PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:PAUL
Last Name:WHITNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1803 MOUNT ROSE AVE
Mailing Address - Street 2:SUITE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3026
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-812-2495
Practice Address - Street 1:1001 S GEORGE ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3676
Practice Address - Country:US
Practice Address - Phone:717-851-4005
Practice Address - Fax:717-812-2495
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD027556E208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA118488OtherUNISON-WMG
PA28385OtherGEISINGER
PA50086679OtherCAPITAL BLUE CROSS
MD610726OtherCAREFIRST MD BCBS
PA1582037OtherGATEWAY
PA20090447OtherAMERIHEALTH MERCY-WMG
PA434603OtherHIGHMARK BLUE SHIELD
PA11187OtherJOHNS HOPKINS
PA4328775OtherAETNA
PA2161248OtherMAMSI-WMG
PA001405059Medicaid
MD034087100Medicaid
PA30131969OtherAMERIHEALTH MERCY - WMG
PA434603FLTMedicare PIN
PA4328775OtherAETNA
B09490Medicare UPIN
PA001405059Medicaid