Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 15829 | NV |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 15829 | NV |
NPI | 1336371400 |
---|---|
Provider Name | Scott Robert Whitlow |
First Address | Reno, NV 89503-4723 |
Second Address | Reno, NV 89503-4723 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2009 |
Last Update Date | 22/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12683812 | CAQH (01) |