Provider Demographics
NPI:1013181577
Name:WHITLEY, MACY ALAYNE (DO)
Entity Type:Individual
Prefix:
First Name:MACY
Middle Name:ALAYNE
Last Name:WHITLEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 N CAMPBELL AVE
Mailing Address - Street 2:PO BOX 245036
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85724-5036
Mailing Address - Country:US
Mailing Address - Phone:520-626-9660
Mailing Address - Fax:520-626-0107
Practice Address - Street 1:1501 N CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-5036
Practice Address - Country:US
Practice Address - Phone:520-626-9660
Practice Address - Fax:520-626-0107
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ5735207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine