Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XL0004X | Low Vision | OC008885 | PA |
NPI | 1184946063 |
---|---|
Provider Name | Dr. Stephen George Whittaker |
First Address | Southampton, PA 18966-4534 |
Second Address | Abington, PA 19001-3714 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2010 |
Last Update Date | 20/11/2013 |