Provider Demographics
NPI:1982686341
Name:WHITING, JOHN C (OD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:C
Last Name:WHITING
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:5 NEPONSET ST FL STREET12
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2714
Mailing Address - Country:US
Mailing Address - Phone:978-345-7398
Mailing Address - Fax:978-353-0035
Practice Address - Street 1:64 BOYDEN RD
Practice Address - Street 2:
Practice Address - City:HOLDEN
Practice Address - State:MA
Practice Address - Zip Code:01520-2570
Practice Address - Country:US
Practice Address - Phone:508-856-9599
Practice Address - Fax:508-829-4988
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2019-03-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA3146152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
4652997OtherAETNA US HEALTHCARE
042472266OtherPRIVATE HEALTHCARE SYSTEM
47244OtherCHILDRENS MEDICAL SECURIT
W16043OtherBLUE CARE ELECT
35481159OtherCIGNA HEALTHSOURCE
60890OtherFALLON COMMUNITY HEALTH P
785969OtherMVP HEALTH CARE
042472266OtherTHREE RIVERS
2213200OtherFIRST HEALTH
AA2170OtherHARVARD PILGRIM HEALTHCAR
042472266OtherTRICARE CHAMPUS
6037084002OtherCIGNA PAL ID
W16043OtherBLUE SHIELD HMO BLUE
MA0334910Medicaid
B291197401OtherCIGNA HEALTH PLAN
W17354Medicare ID - Type UnspecifiedB
MA0334910Medicaid
042472266OtherPRIVATE HEALTHCARE SYSTEM
60890OtherFALLON COMMUNITY HEALTH P