Individual
JAMES E. WITHERELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
88 E MEMORIAL DR, POMEROY, OH 45769-9569
(740) 992-0060
(740) 992-5762
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 992-0060
(740) 992-5762
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
19421
WV
207Q00000X
Family Medicine Physician
Primary
35-04-3845
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000007728
ANTHEM BCBS
—
01
—
000000181976
UNISON MEDICAID
OH
01
—
001714087
MOUNTAIN STATE BCBS
—
05
—
0056199000
—
WV
01
—
0401489
MOLINA MEDICAID
OH
05
—
0401489
—
OH
01
—
080082297
RR MEDICARE
—
01
—
299449901
TRI CARE
OH
01
—
310917085097
CARESOURCE MEDICAID
OH
Enumeration date
06/16/2006
Last updated
02/09/2015
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