Individual
DR. JOHN W WHITESIDE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
833 CHESTNUT ST STE 301, PHILADELPHIA, PA 19107-4405
(215) 955-7190
(215) 955-8600
Mailing address
2333 N 6TH ST, GRAND JUNCTION, CO 81501-2001
(970) 298-1782
(970) 298-1726
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
47640
CO
207Q00000X
Family Medicine Physician
Primary
MD466263
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47008849
—
CO
01
—
840425720-308
HMO#
CO
Enumeration date
11/25/2005
Last updated
02/05/2019
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