Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 6475 | AL |
NPI | 1649287871 |
---|---|
Provider Name | Richard J Whitley |
First Address | Birmingham, AL 35294-0113 |
Second Address | Birmingham, AL 35233-1711 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 01/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000006792 | (05) | AL |
000028874 | (05) | AL |
C76920 | (02) | AL |