Provider Demographics
NPI:1841261666
Name:WHITTINGTON, BETH A (MD)
Entity type:Individual
Prefix:DR
First Name:BETH
Middle Name:A
Last Name:WHITTINGTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1185 W CARMEL DR
Mailing Address - Street 2:D-3
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-8706
Mailing Address - Country:US
Mailing Address - Phone:317-249-0990
Mailing Address - Fax:317-249-0999
Practice Address - Street 1:1185 W CARMEL DR
Practice Address - Street 2:D-3
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-8706
Practice Address - Country:US
Practice Address - Phone:317-249-0990
Practice Address - Fax:317-249-0999
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN010581202084N0400X
IN01058120A2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00164333OtherRR MEDICARE
IN129480500OtherDEPT OF LABOR
IN7910590OtherAETNA REFERRAL NUMBER
IN000000339847OtherANTHEM
IN200491200AMedicaid
IN200491200AMedicaid
IN000000339847OtherANTHEM
IN814200IMedicare ID - Type Unspecified