Individual
JOHNNY E WHITAKER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4881 SUGAR MAPLE DR, WRIGHT PATTERSON AFB, OH 45433-5529
(937) 522-2778
Mailing address
1937 HICKORY RIDGE DR, BEAVERCREEK, OH 45432-4037
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0021603
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
556656
OH
Other
Enumeration date
06/02/2026
Last updated
07/07/2026
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