Organization
JAMES M. WHITTICO, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES M. WHITTICO JR. M.D. (COO)
(314) 367-3400
Entity
Organization
Contact information
Practice address
5535 DELMAR BLVD, SUITE 2400, SAINT LOUIS, MO 63112-3005
(314) 367-3400
(314) 367-3408
Mailing address
5535 DELMAR BLVD, SUITE 2400, SAINT LOUIS, MO 63112-3005
(314) 367-3400
(314) 367-3408
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MDRO700
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200478303
—
MO
Enumeration date
09/23/2008
Last updated
09/23/2008
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