Healthcare Provider Details

I. General information

NPI: 1962523662
Provider Name (Legal Business Name): WHITTINGTON, KOURI & GENTRY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 08/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1758 PARK PL SUITE 201
MONTGOMERY AL
36106-1127
US

IV. Provider business mailing address

1758 PARK PL SUITE 201
MONTGOMERY AL
36106-1127
US

V. Phone/Fax

Practice location:
  • Phone: 334-263-3630
  • Fax: 334-263-3155
Mailing address:
  • Phone: 334-263-3630
  • Fax: 334-263-3155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number13727
License Number StateAL

VIII. Authorized Official

Name: MRS. REBECCA THORNTON
Title or Position: OFFICE MANAGER
Credential:
Phone: 334-263-3630