Whitehead, John A
Whitehead, John A is an individual health care provider with primary practice located at 1055 N 500 W Suite 101, Provo UT 84604-3305. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Whitehead, John A can be contacted via phone (801) 373-4366.Contact Information
Primary practice address
1055 N 500 W Suite 101
Provo UT 84604-3305
Phone: (801) 373-4366
Fax: (801) 429-8191
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 3694731206 | Utah |
Profile Details
| NPI number | 1619935053 |
|---|---|
| LBN Legal business name | Whitehead, John A |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 3rd, 2006 |
| Last updated | Sep 4th, 2023 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619935053 | NPPES |
| Utah | Other | S70943 | UPIN |
| Utah | MEDICAID | 870281028000 | UPIN |
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