Individual
DR. JOHNATHAN JACK WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
400 JOHNSON RIDGE MEDICAL PARK, ELKIN, NC 28621-2447
(336) 526-4500
Mailing address
400 JOHNSON RIDGE MEDICAL PARK, ELKIN, NC 28621-2447
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2015-00253
NC
207X00000X
Orthopaedic Surgery Physician
2806
TN
207X00000X
Orthopaedic Surgery Physician
OS017457
PA
207X00000X
Orthopaedic Surgery Physician
OT013666
PA
Other
Enumeration date
06/11/2010
Last updated
07/08/2015
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