Provider Demographics
NPI:1356369748
Name:WHITFIELD, DAVID JAMES (MSPT, DPT)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JAMES
Last Name:WHITFIELD
Suffix:
Gender:M
Credentials:MSPT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:PORT ST JOE
Mailing Address - State:FL
Mailing Address - Zip Code:32456-1760
Mailing Address - Country:US
Mailing Address - Phone:850-227-7778
Mailing Address - Fax:850-227-7999
Practice Address - Street 1:502 E 4TH ST
Practice Address - Street 2:
Practice Address - City:PORT ST JOE
Practice Address - State:FL
Practice Address - Zip Code:32456-1760
Practice Address - Country:US
Practice Address - Phone:850-227-7778
Practice Address - Fax:850-227-7999
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 0010245225100000X, 2251G0304X, 2251N0400X, 2251P0200X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY8346OtherBLUE CROSS / BLUE SHIELD
FLY8346OtherBLUE CROSS / BLUE SHIELD