Organization
JCWHIT P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN C WHITAKER M.D. (PHYSICIAN)
(479) 484-5645
Entity
Organization
Contact information
Practice address
2713 S 74TH ST, SUITE 408, FORT SMITH, AR 72903-5170
(479) 484-5646
Mailing address
2713 S 74TH ST, SUITE 408, FORT SMITH, AR 72903-5170
(479) 484-5646
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
C-7165
AR
Other
Enumeration date
02/15/2007
Last updated
08/22/2020
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