Provider Demographics
NPI:1336149814
Name:WHITTINGTON, BRIEN J (DO)
Entity Type:Individual
Prefix:DR
First Name:BRIEN
Middle Name:J
Last Name:WHITTINGTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8890 N UNION BLVD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7799
Mailing Address - Country:US
Mailing Address - Phone:719-364-5005
Mailing Address - Fax:719-365-9911
Practice Address - Street 1:8890 N UNION BLVD
Practice Address - Street 2:SUITE 170
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7799
Practice Address - Country:US
Practice Address - Phone:719-364-5005
Practice Address - Fax:719-365-9911
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO28716207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO332623YLB8Medicare PIN
COWHA29093OtherBC/BS
CO8F22453Medicare PIN
CO332623YLB8Medicare PIN