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Keith Randall Whitesides, MD
Family Medicine Physician in Lafayette, Indiana
NPI 1548229644

Keith Randall Whitesides is a Family Medicine Physician based in Lafayette, IN. Keith Randall Whitesides practices in Lafayette, IN and has the professional credentials of MD. The NPI Number for Keith Randall Whitesides is 1548229644 and holds a License No. 01032200A (Indiana).

The current practice location address for Keith Randall Whitesides is 2800 Ferry St, Lafayette, IN and can be reached out via phone at 765-448-8000 and via fax at 765-447-9749.

Location: 2800 Ferry St, Lafayette, IN, 47903-5545
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1548229644
Provider Name
Keith Randall Whitesides
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
2800 Ferry St, Lafayette, IN, 47903-5545
Phone Number
765-448-8000
Fax Number
765-447-9749
Provider Enumeration Date
03/20/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
431714 01 IN PHCS PID NUMBER
000000190237 01 IN ANTHEM PROVIDER NUMBER
10826183 01 IN CAQH NUMBER
200100480 05 IN
institution
Provider Business Practice Location Address Details
Address
2800 Ferry St
City
Lafayette
State
Indiana
Zip
47904-3022
Phone Number
765-448-8000
Fax Number
765-447-9749
person
Provider Business Mailing Address Details
Address
2800 Ferry St
City
Lafayette
State
Indiana
Zip
47904-3022
Phone Number
765-448-8000
Fax Number
765-447-9749
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
01032200A (Indiana)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
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