Provider Demographics
NPI:1356534010
Name:JOHN C WHELTON MD PA
Entity type:Organization
Organization Name:JOHN C WHELTON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:WHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-833-6700
Mailing Address - Street 1:1411 N FLAGLER DRIVE
Mailing Address - Street 2:SUITE 3100
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3414
Mailing Address - Country:US
Mailing Address - Phone:561-833-6700
Mailing Address - Fax:561-833-6306
Practice Address - Street 1:1411 N FLAGLER DR
Practice Address - Street 2:SUITE 3100
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3414
Practice Address - Country:US
Practice Address - Phone:561-833-6700
Practice Address - Fax:561-833-6306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0022206207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAE930OtherPTAN
FLD55794Medicare UPIN