Provider Demographics
NPI:1720056013
Name:WHITMER, JAMIE HOWARD (DC)
Entity Type:Individual
Prefix:MR
First Name:JAMIE
Middle Name:HOWARD
Last Name:WHITMER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:HOLSTEIN
Mailing Address - State:IA
Mailing Address - Zip Code:51025-0190
Mailing Address - Country:US
Mailing Address - Phone:712-368-4547
Mailing Address - Fax:712-368-4702
Practice Address - Street 1:800 S. MAIN ST.
Practice Address - Street 2:
Practice Address - City:HOLSTEIN
Practice Address - State:IA
Practice Address - Zip Code:51025-0190
Practice Address - Country:US
Practice Address - Phone:712-368-4547
Practice Address - Fax:712-368-4702
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06516111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP00274054OtherRAILROAD MEDICARE
IA33663OtherBLUE CROSS BLUE SHIELD
IA5256222Medicaid
IAU90412Medicare UPIN
IA5256222Medicaid