Kent B Whitaker, PA

NPI #1487635579 in Logan, Utah

Provider Information

NPI Number: 1487635579
Entity Type: Individual
Name: Kent B Whitaker, PA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Nov 7, 2005
Last Updated: May 15, 2008

Practice Location

Address: 550 E 1400 N
Address 2: SUITE R
City: Logan
State: Utah
ZIP Code: 84341-2406
Phone: (435) 755-9484

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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