# DR. GERALD L WHITESIDE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1801863477
- **Gender:** Man
- **Credential:** AUD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 231H00000X | Audiologist | 1983 | KS | Yes |
| 237600000X | Audiologist-Hearing Aid Fitter | 1252 | KS | — |

## Other

- **Enumeration date:** 03/02/2006
- **Last updated:** 11/16/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 115852 | BCBS OF KANSAS | — |
| 01 | — | 11839028 | CAQH | — |
| 05 | — | 200386610A | — | KS |
| 01 | — | 39948015 | BCBS OF KANSAS CITY | — |