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Individual

DR. LEE CARL WHITAKER

Active
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Individual

DR. LEE CARL WHITAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD000035229
TN
207QA0505X
Adult Medicine Physician
Primary
1625
VI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009911897
—
AL
01
—
1508809625
NPI
TN
Enumeration date
06/14/2006
Last updated
05/09/2012
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