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Individual

DR. JOSEPH D. WHITLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
905 UNIVERSITY DR, STATE COLLEGE, PA 16801-6626
(814) 238-8418
(814) 234-2888
Mailing address
905 UNIVERSITY DR, STATE COLLEGE, PA 16801-6626
(814) 238-8418
(814) 234-2888

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
000722778
NC
208600000X
Surgery Physician
MD039559E
PA
2086S0129X
Vascular Surgery Physician
000722778
NC
2086S0129X
Vascular Surgery Physician
MD039559E
PA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
000722778
NC
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD039559E
PA
225100000X
Physical Therapist
2471V0105X
Vascular Sonography Radiologic Technologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12953
BLUE CROSS
NC
01
2293437A
MEDICARE ID
NC
05
8912953
NC
Enumeration date
01/13/2006
Last updated
11/18/2015
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