Healthcare Provider Details

I. General information

NPI: 1821373093
Provider Name (Legal Business Name): JOSHUA MARK WHITLEY PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2011
Last Update Date: 07/02/2020
Certification Date: 07/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 6TH AVE S
BIRMINGHAM AL
35233-2110
US

IV. Provider business mailing address

2000 6TH AVE S FL 2
BIRMINGHAM AL
35233-2110
US

V. Phone/Fax

Practice location:
  • Phone: 205-801-8730
  • Fax:
Mailing address:
  • Phone: 205-801-8732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17661
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: