Healthcare Provider Details

I. General information

NPI: 1477517449
Provider Name (Legal Business Name): LYNN K WHITTINGTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2019 NORMANDIE DR
MONTGOMERY AL
36111-2711
US

IV. Provider business mailing address

2019 NORMANDIE DR
MONTGOMERY AL
36111-2711
US

V. Phone/Fax

Practice location:
  • Phone: 334-281-7523
  • Fax: 334-281-7912
Mailing address:
  • Phone: 334-281-7523
  • Fax: 334-281-7912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number14620
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: