Organization
COMPREHENSIVE WOUND CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH D WHITLARK MD (OWNER)
(252) 939-9300
Entity
Organization
Contact information
Practice address
204 AIRPORT ROAD, KINSTON, NC 28504-8814
(252) 527-9928
(252) 527-9929
Mailing address
PO BOX 5485, KINSTON, NC 28503-5485
(252) 527-9928
(252) 527-9929
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
Primary
—
—
225100000X
Physical Therapist
—
—
2471V0105X
Vascular Sonography Radiologic Technologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015VR
BCBS GROUP
NC
05
—
89015VR
—
NC
Enumeration date
02/01/2006
Last updated
09/20/2012
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