Individual
RICHARD JAMES WHITEHEAD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
410 SAYBROOK RD, SUITE 201, MIDDLETOWN, CT 06457-4777
(860) 347-4620
(860) 344-5995
Mailing address
410 SAYBROOK RD, SUITE 201, MIDDLETOWN, CT 06457
(860) 347-4620
(860) 346-9687
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0000881
CT
363AM0700X
Medical Physician Assistant
000881
CT
Other
Enumeration date
12/16/2005
Last updated
03/25/2015
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