Healthcare Provider Details

I. General information

NPI: 1548138043
Provider Name (Legal Business Name): GEORGE A. WHILLOCK RN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200B SPRING HILL AVE
MOBILE AL
36604-2718
US

IV. Provider business mailing address

PO BOX 41241
MOBILE AL
36640-1241
US

V. Phone/Fax

Practice location:
  • Phone: 251-405-3677
  • Fax: 251-405-3233
Mailing address:
  • Phone: 251-405-3677
  • Fax: 251-405-3233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number1-079911
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: