Provider Demographics
NPI:1144797556
Name:WHITTLE, WILLIAM MURPHY
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:MURPHY
Last Name:WHITTLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 HALLUM ST
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-8684
Mailing Address - Country:US
Mailing Address - Phone:850-461-9033
Mailing Address - Fax:
Practice Address - Street 1:2000 HALLUM ST
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-8684
Practice Address - Country:US
Practice Address - Phone:850-461-9033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians