Individual
JEFFREY BRAY WHITEHURST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
112 HAVEN DRIVE, SUITE 1, DOTHAN, AL 36301
(334) 671-5050
(334) 671-5070
Mailing address
112 HAVEN DRIVE, SUITE 1, DOTHAN, AL 36301
(334) 671-5050
(334) 671-5070
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
18421
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00793163B
—
GA
05
—
051510147
—
AL
Enumeration date
09/12/2005
Last updated
03/18/2010
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