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General NPI Number Information
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NPI Number | 1053970228
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Entity Type | Individual
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Provider Name | JONATHON DAVID WHITEHEAD MD
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Gender | Male
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Dates
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Enumeration Date | 06/11/2019
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 4517 SOUTHLAKE PKWY
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City | HOOVER
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State | AL
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Zip | 35244-3280
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Country | US
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Telephone | 205-985-4111
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Fax | 205-985-4326
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Provider Business Mailing Address
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Address Line | PO BOX 117709
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City | ATLANTA
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State | GA
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Zip | 30368-7709
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Country | US
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Telephone | 205-985-4111
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Fax | 205-985-4326
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MD.48532
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 11070
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | MD.48532
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License Number State | AL
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