Individual
MR. KARL WHITING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
601 E I65 SERVICE RD S, MOBILE, AL 36606-3901
(251) 479-4458
(251) 479-4824
Mailing address
PO BOX 850531, MOBILE, AL 36685-0531
(251) 479-4458
(251) 479-4824
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3A90TA658
AL
152W00000X
Optometrist
S-A90-TA-658
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051524367
MEDICARE PROVIDER NUMBER
AL
01
—
51524367
BCBS PROVIDER NUMBER
AL
05
—
631400152
—
AL
05
—
631409152
—
AL
Enumeration date
04/04/2006
Last updated
01/26/2023
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