Provider Demographics
NPI:1073234852
Name:WHITEHURST, JOHN (BILLING PROVIDER)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:WHITEHURST
Suffix:
Gender:M
Credentials:BILLING PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AL
Mailing Address - Zip Code:36360-2032
Mailing Address - Country:US
Mailing Address - Phone:334-694-1200
Mailing Address - Fax:
Practice Address - Street 1:189 W REYNOLDS ST
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360-1438
Practice Address - Country:US
Practice Address - Phone:334-694-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246YC3302XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Physician Office Based
No246YC3301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Hospital Based
No282J00000XHospitalsReligious Nonmedical Health Care Institution
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner
No374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing Personnel