Individual
ZACHARY JORDAN WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1 MEADOWS PKWY, VIDALIA, GA 30474-8759
(912) 535-5555
Mailing address
1056 C.V. MOSLEY BLVD, VIDALIA, GA 30474
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6460
GA
Other
Enumeration date
04/27/2012
Last updated
05/15/2021
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