Whetzel, Jerry Warren

Whetzel, Jerry Warren is an individual health care provider with primary practice located at 430 W Votaw St , Portland IN 47371-1302. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Whetzel, Jerry Warren can be contacted via phone (260) 726-7616.

Contact Information

Primary practice address
430 W Votaw St Portland IN 47371-1302
Phone: (260) 726-7616
Fax: (260) 726-8165
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01051865 Indiana

Profile Details

NPI number 1215935705
LBN Legal business name Whetzel, Jerry Warren
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2005
Last updated Apr 2nd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215935705 NPPES
Indiana MEDICAID 200249490
Indiana Other 000000308400
Indiana Other 8659

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