Basic Information
Provider Information
NPI: 1427391424
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WHALEY
FirstName: KAITLIN
MiddleName: GIBLER
NamePrefix:  
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Credential:  
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Mailing Information
Address1: 3333 BURNET AVE # MLC5021
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452293026
CountryCode: US
TelephoneNumber: 5136364225
FaxNumber: 5136362511
Practice Location
Address1: 3333 BURNET AVE
Address2: ML 2010
City: CINCINNATI
State: OH
PostalCode: 452293026
CountryCode: US
TelephoneNumber: 5136364415
FaxNumber: 5136367805
Other Information
ProviderEnumerationDate: 03/28/2013
LastUpdateDate: 09/30/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0206X35.129098OHY Allopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology

No ID Information.


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