Individual
DR. KEITH GARRETT WHITLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3009 NEW BERN AVE, RALEIGH, NC 27610-1214
(630) 200-2738
Mailing address
2319 WILMINGTON CT, NAPERVILLE, IL 60565-5382
(630) 200-2738
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2024-00594
NC
207XX0801X
Orthopaedic Trauma Physician
Primary
2024-00594
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2024-00594
—
NC
Enumeration date
04/01/2018
Last updated
09/19/2024
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