Provider Demographics
NPI:1174586911
Name:WHISNANT, JOSEPH DURWOOD (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:DURWOOD
Last Name:WHISNANT
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 1:180 FOY DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-2417
Mailing Address - Country:US
Mailing Address - Phone:252-443-3136
Mailing Address - Fax:252-443-3847
Practice Address - Street 1:180 FOY DR
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-2417
Practice Address - Country:US
Practice Address - Phone:252-443-3136
Practice Address - Fax:252-443-3847
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17456208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8986859Medicaid
NC86859OtherBCBS OF NC
NC86859OtherBCBS OF NC
NC8986859Medicaid
NC211467Medicare ID - Type Unspecified