Provider Demographics
NPI:1992739031
Name:WHITEMAN, JULES (MD)
Entity type:Individual
Prefix:
First Name:JULES
Middle Name:
Last Name:WHITEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 833
Mailing Address - Street 2:BLDG 2 STE 1
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-0833
Mailing Address - Country:US
Mailing Address - Phone:785-650-9852
Mailing Address - Fax:706-653-8732
Practice Address - Street 1:2501 E 13TH ST
Practice Address - Street 2:BLDG 2 STE 1
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2764
Practice Address - Country:US
Practice Address - Phone:785-625-6521
Practice Address - Fax:785-625-3525
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361162862085R0202X
KS04308852085R0202X
CO452132085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200270680BMedicaid
KS106002Medicare PIN
KS200270680BMedicaid