MEDICARE: CORTNEY MARIA WHITTINGTON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME110869	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902117138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORTNEY MARIA WHITTINGTON MD

Provider Business Mailing Address
First Line	:	2888 MAHAN DR STE 6
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-5465
Country	:	US
Telephone Number	:	850-942-2233
Fax Number	:	850-942-1048

Provider Business Practice Location Address
First Line	:	2888 MAHAN DR STE 6
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-5465
Country	:	US
Telephone Number	:	850-942-2233
Fax Number	:	850-942-1048

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2010
Last Update Date	:	05/02/2022

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