Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 2004018893 | MO |
NPI | 1093714347 |
---|---|
Provider Name | Dr. Joseph Craig Whitt |
First Address | Leawood, KS 66209-1718 |
Second Address | Kansas City, MO 64108-2716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2005 |
Last Update Date | 30/11/2009 |