Individual
JOHN R WHITWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
806 ESTATE PL, MEMPHIS, TN 38120-0600
(901) 681-4017
(901) 681-4013
Mailing address
2670 UNION AVENUE EXT, SUITE 1220, MEMPHIS, TN 38112-4426
(901) 458-9785
(901) 458-8192
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
34143
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02724221
—
MS
05
—
185482
—
TN
05
—
19169
—
TN
05
—
3387689
—
TN
01
—
4128673
BLUE CROSS
TN
05
—
4128673
—
TN
01
—
98990
BLUE CROSS
AR
01
—
H41886
HEALTHSOURCE
TN
Enumeration date
07/07/2006
Last updated
07/09/2007
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