=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518911999
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TIMOTHY J WHALEN MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/20/2006
-----------------------------------------------------
Last Update Date | 12/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1800 BEVERLY AVE
-----------------------------------------------------
City | MUSCLE SHOALS
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35661-3255
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-288-3333
-----------------------------------------------------
Fax | 256-429-9411
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 600 SUN TEMPLE DR
-----------------------------------------------------
City | MADISON
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35758-8643
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-288-3333
-----------------------------------------------------
Fax | 256-429-9411
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | 27330
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084P0804X
-----------------------------------------------------
Taxonomy Name | Child & Adolescent Psychiatry Physician
-----------------------------------------------------
License Number | MD.27330
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------