Individual
MANDY JONN WHITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9342 CEDAR CENTER WAY, LOUISVILLE, KY 40291-4522
(502) 239-3228
(502) 231-2517
Mailing address
PO BOX 950202, LOUISVILLE, KY 40295-0202
(502) 588-9490
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
45723
KY
207Q00000X
Family Medicine Physician
TRN 15290
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100256480
—
KY
Enumeration date
06/16/2010
Last updated
10/13/2015
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