Provider Demographics
NPI:1578902516
Name:WHITTINGTON, EDWARD C I (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:C
Last Name:WHITTINGTON
Suffix:I
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 1:4832 SOUTHLAKE PKWY
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-3393
Mailing Address - Country:US
Mailing Address - Phone:205-985-4598
Mailing Address - Fax:
Practice Address - Street 1:4832 SOUTHLAKE PKWY
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-3393
Practice Address - Country:US
Practice Address - Phone:205-985-4598
Practice Address - Fax:205-985-4599
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-24
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7211261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center