Individual
JACOB CLARK WHITSITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1850 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3212
(720) 494-3118
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
CDRH.0063067
CO
207N00000X
Dermatology Physician
Primary
DR.0063067
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2015
Last updated
03/04/2026
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