Individual
DR. GRANT TYLER WHITTAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1348 SOUTH 18TH STREET, SUITE 100, FERNANDINA BEACH, FL 32034-4755
(904) 261-0879
(904) 277-7054
Mailing address
4800 BELFORT RD, JACKSONVILLE, FL 32256-6004
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD 30868
AL
207R00000X
Internal Medicine Physician
ME 105816
FL
207RG0100X
Gastroenterology Physician
Primary
ME105816
FL
Other
Enumeration date
07/03/2007
Last updated
08/27/2014
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