Individual
DR. GERALD L WHITESIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AUD
Contact information
Practice address
1112 W 6TH ST, SUITE 100, LAWRENCE, KS 66044-2249
(785) 843-8479
(785) 843-8481
Mailing address
1112 W 6TH ST, SUITE 100, LAWRENCE, KS 66044-2249
(785) 843-8479
(785) 843-8481
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1983
KS
237600000X
Audiologist-Hearing Aid Fitter
1252
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115852
BCBS OF KANSAS
—
01
—
11839028
CAQH
—
05
—
200386610A
—
KS
01
—
39948015
BCBS OF KANSAS CITY
—
Enumeration date
03/02/2006
Last updated
11/16/2020
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