Provider Demographics
NPI:1295708493
Name:WHISMAN, SALLI E (MD)
Entity type:Individual
Prefix:DR
First Name:SALLI
Middle Name:E
Last Name:WHISMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SALLI
Other - Middle Name:E
Other - Last Name:GALLAHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2312 ALEXANDRIA DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3229
Mailing Address - Country:US
Mailing Address - Phone:859-276-5344
Mailing Address - Fax:859-296-0362
Practice Address - Street 1:1733 HARRODSBURG RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3277
Practice Address - Country:US
Practice Address - Phone:859-276-5344
Practice Address - Fax:859-296-0362
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY33183207Q00000X
KY39786207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYG82998Medicare UPIN
KY0576311Medicare ID - Type Unspecified