Individual
DR. LAURA LEANNE WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
22894 US HIGHWAY 72, ATHENS, AL 35613
(256) 232-2409
(256) 232-2402
Mailing address
22894 US HIGHWAY 72, ATHENS, AL 35613
(256) 232-2409
(256) 232-2402
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S889TA445
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4835600001
DME
AL
01
—
51514732
BCBS
AL
05
—
51514732
—
AL
Enumeration date
01/18/2006
Last updated
03/14/2019
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