Individual
DR. JIM HAYES WHITESIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1004 GLENVIEW DR, GLASGOW, KY 42141-3424
(270) 651-9611
(270) 651-9298
Mailing address
1004 GLENVIEW DR, GLASGOW, KY 42141-3424
(270) 651-9611
(270) 651-9298
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
18627
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000048056
ANTHEM BC/BS
KY
01
—
408013739
RAILROAD MEDICARE
KY
05
—
64186273
—
KY
Enumeration date
02/13/2006
Last updated
03/29/2016
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