Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 013632 | LA |
Y | 208600000X | Surgeon | 013632 | LA |
NPI | 1013007988 |
---|---|
Provider Name | Dr. John Mcalister Whitaker |
First Address | Baton Rouge, LA 70808-4300 |
Second Address | Baton Rouge, LA 70808-4300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 28/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00121503 | (05) | MS |
1163881 | (05) | LA |
C61339 | (02) | LA |