Individual
MARK D WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
19636 N 27TH AVE, SUITE 308, PHOENIX, AZ 85027-4013
(623) 780-1999
(623) 516-0950
Mailing address
2500 W UTOPIA RD, STE. 100, PHOENIX, AZ 85027-4171
(623) 780-1999
(623) 516-0950
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2347
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279704
—
AZ
Enumeration date
08/08/2006
Last updated
02/02/2015
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