Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 002457 | GA |
NPI | 1003014762 |
---|---|
Provider Name | Dr. Joshua Blake Wharton |
First Address | Guntersville, AL 35976-2205 |
Second Address | Guntersville, AL 35976-2205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2007 |
Last Update Date | 02/02/2012 |