Individual
DR. SCOTT DELANO WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD MD
Contact information
Practice address
2886 S LAMAR BLVD, OXFORD, MS 38655
(662) 236-7888
(662) 236-2025
Mailing address
PO BOX 1503, OXFORD, MS 38655
(662) 236-7888
(662) 236-2025
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
14210
MS
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
263991
MS
Other
Enumeration date
11/30/2006
Last updated
07/08/2007
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