Provider Demographics
NPI:1235244930
Name:WHITMAN, EMILY JOLYNDA (OD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:JOLYNDA
Last Name:WHITMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9237 GREENSBORO CT
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7438
Mailing Address - Country:US
Mailing Address - Phone:850-292-7062
Mailing Address - Fax:
Practice Address - Street 1:9237 GREENSBORO CT
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7438
Practice Address - Country:US
Practice Address - Phone:850-292-7062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4184152W00000X
TNOD0000003066152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
11658031OtherCAQH
FLAE784ZOtherMEDICARE
FL36010OtherBCBS OF FLORIDA
9551077OtherAETNA