Healthcare Provider Details

I. General information

NPI: 1346206414
Provider Name (Legal Business Name): JOSHUA ANDREW WHIDDON D. C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47795 US HIGHWAY 78
LINCOLN AL
35096-6755
US

IV. Provider business mailing address

47795 US HIGHWAY 78
LINCOLN AL
35096-6755
US

V. Phone/Fax

Practice location:
  • Phone: 205-763-2222
  • Fax:
Mailing address:
  • Phone: 205-763-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2123
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: