Individual
MR. JOEL T WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
140 ACADEMY ST, PRESQUE ISLE, ME 04769-3102
(207) 768-4100
(207) 768-5840
Mailing address
140 ACADEMY ST, PRESQUE ISLE, ME 04769-3102
(207) 768-4100
(207) 768-5840
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1876
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA1876
MAINE LICENSE
ME
Enumeration date
11/07/2018
Last updated
11/07/2018
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