person
Jerry David Whatley, MD
Adolescent Medicine (Family Medicine) Physician in Ardmore, Oklahoma
NPI 1780634816

Jerry David Whatley is an Adolescent Medicine (Family Medicine) Physician based in Ardmore, OK and is specialized in Adolescent Medicine. Jerry David Whatley practices in Ardmore, OK and has the professional credentials of MD. The NPI Number for Jerry David Whatley is 1780634816 and holds a License No. 19096 (Oklahoma).

The current practice location address for Jerry David Whatley is 509 Grand Ave, Ardmore, OK and can be reached out via phone at 580-223-3300 and via fax at 580-223-3320. You can also correspond with Jerry David Whatley through the mailing address at 936 DEESE RD, ARDMORE, OK - 73401-9315 (mailing address contact number: 580-224-9035).

Location: 509 Grand Ave, Ardmore, OK, 73401-9315
person
Provider Profile Details
NPI Number
1780634816
Provider Name
Jerry David Whatley
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
509 Grand Ave, Ardmore, OK, 73401-9315
Phone Number
580-223-3300
Fax Number
580-223-3320
Provider Enumeration Date
05/11/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100114070G 01 OK SOONERCARE MCD #
19096 01 OK OKLAHOMA LICENSE #
731612230 01 OK TAX ID #
100114070A 05 OK
institution
Provider Business Practice Location Address Details
Address
509 Grand Ave
City
State
Zip
73401-4338
Phone Number
580-223-3300
Fax Number
580-223-3320
person
Provider Business Mailing Address Details
Address
509 Grand Ave
City
State
Zip
73401-4338
Phone Number
580-223-3300
Fax Number
580-223-3320
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
Adolescent Medicine
Taxonomy
License No.
19096 (Oklahoma)
Definition
A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs.
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