Individual
DR. JOHN B. WHITLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
407 S GREENWOOD ST, LAGRANGE, GA 30240-3123
(706) 882-0616
(706) 882-8515
Mailing address
407 S GREENWOOD ST, LAGRANGE, GA 30240-3123
(706) 882-0616
(706) 882-8515
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001301
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000546125A
—
GA
01
—
0522840001
DMERC
GA
01
—
410024976
MEDICARE RAILROAD RETIREM
GA
01
—
5243394001
BLUE CROSS BLUE SHIELD
GA
Enumeration date
09/19/2005
Last updated
07/06/2010
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