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Individual

KARL WHITLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3509 N BROAD ST, PHILA, PA 19140-4105
(215) 707-3663
(215) 226-8286
Mailing address
2450 W HUNTING PARK AVE, 3/208N, PHILADELPHIA, PA 19129-1302
(215) 707-3663
(215) 707-7523

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD049534L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001560548
PA
01
0745640000
INDEPENDENCE BLUE CROSS
PA
01
17012
BRAVO HEALTH
PA
01
30011554
KEYSTONE MERCY HEALTH
PA
01
519043
COVENTRY HEALTH AMERICA
PA
01
5558502
AETNA PPO
PA
01
562290
HIGHMARK BLUE SHIELD
PA
01
P00313454
RAILROAD MEDICARE
PA
Enumeration date
09/30/2005
Last updated
10/09/2017
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