Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 8866272 | UT |
NPI | 1003895582 |
---|---|
Provider Name | Dr. Joy R Whipple |
First Address | Midway, UT 84049-6828 |
Second Address | Midway, UT 84049-6828 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2006 |
Last Update Date | 05/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4996088 | WELLMARK NUMBER (01) | SD |
5701100 | (05) | SD |
H92568 | (02) | SD |
P00045049 | RAILROAD MEDICARE (01) | SD |