Individual
JEFFREY CLEMENT WHITTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
PC/00 CLEMENT J ZABLOCKI VA MEDICAL CTR, 5000 W. NATIONAL AVE, MILWAUKEE, WI 53295-0001
(414) 384-2000
(414) 382-5017
Mailing address
PC/00 CLEMENT J ZABLOCKI VA MEDICAL CTR, 5000 W. NATIONAL AVE, MILWAUKEE, WI 53295-0001
(414) 384-2000
(414) 382-5017
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
48151-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48151-020
MEDICAL LICENSE
WI
Enumeration date
07/19/2006
Last updated
07/08/2007
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