Organization
WHITAKER NATIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MOORE (CFO)
(415) 435-4591
Entity
Organization
Contact information
Practice address
859 ALDERSON ST, WILLIAMSON, WV 25661-3215
(304) 235-2500
Mailing address
PO BOX 409013, ATLANTA, GA 30384-9013
(800) 377-8721
(304) 523-2241
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008085001
—
WV
05
—
6593134700
—
KY
01
—
CF8194
RR MEDICARE
—
Enumeration date
06/02/2008
Last updated
01/02/2014
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