Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 6048 | OK |
N | 213EG0000X | General Practice | 6048 | OK |
Y | 1223P0221X | Pediatric Dentist | 83 | OK |
NPI | 1093965626 |
---|---|
Provider Name | Dr. Heath Austin Whitfield |
First Address | Edmond, OK 73013-5778 |
Second Address | Edmond, OK 73013-5778 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2008 |
Last Update Date | 25/08/2011 |