Provider Demographics
NPI:1417919648
Name:WHITING, KARL (DO)
Entity Type:Individual
Prefix:MR
First Name:KARL
Middle Name:
Last Name:WHITING
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 850531
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36685-0531
Mailing Address - Country:US
Mailing Address - Phone:251-479-4458
Mailing Address - Fax:251-479-4824
Practice Address - Street 1:601 E I65 SERVICE RD S
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-3901
Practice Address - Country:US
Practice Address - Phone:251-479-4458
Practice Address - Fax:251-479-4824
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-A90-TA-658152W00000X
AL3A90TA658152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL631400152Medicaid
AL51524367OtherBCBS PROVIDER NUMBER
AL051524367OtherMEDICARE PROVIDER NUMBER
AL631409152Medicaid
AL051524367Medicare PIN
AL51524367OtherBCBS PROVIDER NUMBER