Provider Demographics
NPI:1326130477
Name:WHITLEY, WILLIAM CRAIG (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CRAIG
Last Name:WHITLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 7TH ST SE STE 240
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-3397
Mailing Address - Country:US
Mailing Address - Phone:256-355-5315
Mailing Address - Fax:256-355-5346
Practice Address - Street 1:1215 7TH ST SE STE 240
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3397
Practice Address - Country:US
Practice Address - Phone:256-355-5315
Practice Address - Fax:256-355-5346
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00012638207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL4044829OtherAETNA
AL51015869Medicare ID - Type Unspecified
ALC74340Medicare UPIN