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Individual

BROOKS A WHITNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
036903
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003118708A
GA
05
003118708B
GA
05
003118708C
GA
05
003118708D
GA
05
003118708E
GA
05
003118708F
GA
05
003118708G
GA
05
003118708H
GA
05
003118708I
GA
05
003118708J
GA
05
00543628A
GA
01
770000209
RR MCE
GA
Enumeration date
06/09/2006
Last updated
02/26/2021
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