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General NPI Number Information
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NPI Number | 1568785277
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Entity Type | Organization
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Legal Business Name | DONALD W WHITAKER MD PA
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 07/22/2014
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Provider Practice Location Address
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Address Line | 924 MAR WALT DR
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City | FORT WALTON BEACH
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State | FL
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Zip | 32547-6706
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Country | US
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Telephone | 850-863-1000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2617
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City | FORT WALTON BEACH
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State | FL
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Zip | 32549-2617
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Country | US
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Telephone | 850-863-1000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DONALD W WHITAKER
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Credential | M.D.
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Telephone | 850-855-6707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME66730
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License Number State | FL
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