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Individual

THOMAS M WHITTEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1060 S MAIN ST STE 2, TIPTON, IN 46072-8327
(765) 675-9889
(888) 544-9037
Mailing address
1060 S MAIN ST STE 2, TIPTON, IN 46072-8327
(765) 675-9889
(888) 544-9037

Taxonomy

Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
01055526A
IN
208600000X
Surgery Physician
Primary
01055526
IN
2086S0129X
Vascular Surgery Physician
01055526A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000320783
ANTHEM
IN
05
200356650
IN
01
Q0089831
SHO
IN
Enumeration date
12/29/2005
Last updated
01/20/2016
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