Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 1630 | AL |
NPI | 1003169392 |
---|---|
Provider Name | Dr. Jeffrey Alston Whitener |
First Address | Mobile, AL 36606-1433 |
Second Address | Bay Minette, AL 36507-4110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2012 |
Last Update Date | 24/03/2021 |