Individual
DR. JUSTIN KYLE WHITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
221 N CELIA AVE, MUNCIE, IN 47303-4609
(765) 747-4454
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01059651A
IN
207V00000X
Obstetrics & Gynecology Physician
01059651A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200512990
—
IN
01
—
P00820082
RAILROAD MEDICARE
IN
Enumeration date
07/04/2006
Last updated
03/01/2021
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