Individual
THEODORE M. WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
12140 NALL AVE STE 100, OVERLAND PARK, KS 66209-2504
(816) 943-0406
(913) 451-1754
Mailing address
12140 NALL AVE STE 100, OVERLAND PARK, KS 66209-2504
(816) 943-0406
(913) 451-1754
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R1D87
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
242039642
—
MO
Enumeration date
10/31/2005
Last updated
03/17/2018
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