Individual provider · Type 1 NPI
Jerry David Whatley, MD
Adolescent Medicine (Family Medicine) Physician · Ardmore, OK
NPI number
1780634816
Active
Practice location
509 Grand Ave
Ardmore, OK 73401-4338
Fax (580) 223-3320
Mailing address
936 Deese Rd
Ardmore, OK 73401-9315
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adolescent Medicine (Family Medicine) Physician Primary | 207QA0000X | 19096 (OK) |
Adolescent Medicine (Family Medicine) Physician: A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs.
About NPI 1780634816
Jerry David Whatley, MD's National Provider Identifier is 1780634816, issued on May 11, 2006. The primary taxonomy on file is Adolescent Medicine (Family Medicine) Physician (207QA0000X), and the practice location is in Ardmore, OK. The record was last updated on Jan 7, 2011.