Individual
TIQUELLA SHANTEL KING-WHITBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
685 ARLINGTON PL, MACON, GA 31201-1772
(478) 292-2060
Mailing address
685 ARLINGTON PL, MACON, GA 31201-1772
(478) 292-2060
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
058891
GA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
58891
GA
Other
Enumeration date
02/05/2008
Last updated
07/21/2022
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