Provider Demographics
NPI:1275870115
Name:WIHBEY, GEORGE WAYNE
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:WAYNE
Last Name:WIHBEY
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 1:1033 A1A BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-6731
Mailing Address - Country:US
Mailing Address - Phone:904-461-0236
Mailing Address - Fax:
Practice Address - Street 1:1033 A1A BEACH BLVD
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-6731
Practice Address - Country:US
Practice Address - Phone:904-461-0236
Practice Address - Fax:904-460-1025
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS33748183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist