Individual
DR. JAMES MICHAEL WHITENECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7001 ROGERS AVE, SUITE 401, FORT SMITH, AR 72903-4073
(479) 314-4650
(479) 452-1196
Mailing address
7001 ROGERS AVE, SUITE 401, FORT SMITH, AR 72903-4073
(479) 314-4650
(479) 452-1196
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
16062
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100100530A
—
OK
01
—
2673528
MEDICARE
AR
01
—
5I280
BLUE CROSS BLUE SHIELD
AR
Enumeration date
10/16/2006
Last updated
07/01/2013
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