Provider Demographics
NPI:1831191691
Name:WHITFORD FAMILY MEDICINE, P.C.
Entity type:Organization
Organization Name:WHITFORD FAMILY MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:COOPERSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-873-2155
Mailing Address - Street 1:102 SCHUBERT DR
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-3382
Mailing Address - Country:US
Mailing Address - Phone:610-873-2155
Mailing Address - Fax:610-873-8494
Practice Address - Street 1:102 SCHUBERT DR
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-3382
Practice Address - Country:US
Practice Address - Phone:610-873-2155
Practice Address - Fax:610-873-8494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-11
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-005991-L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA168000OtherHIGHMARK BLUE CROSS
PA847OtherAETNA
PADN3792OtherRAILROAD MEDICARE
PAP2381468OtherOXFORD
PA0372127001OtherKEYSTONE AND PERS. CHOICE
PAP2381468OtherOXFORD
PADN3792OtherRAILROAD MEDICARE