Provider Demographics
NPI:1760535082
Name:WEBB, WHITNEY L (MD)
Entity Type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:L
Last Name:WEBB
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 1:1010 PRINCE AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-5805
Mailing Address - Country:US
Mailing Address - Phone:706-353-1630
Mailing Address - Fax:
Practice Address - Street 1:1010 PRINCE AVE STE 400
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-5805
Practice Address - Country:US
Practice Address - Phone:706-425-1400
Practice Address - Fax:706-548-0184
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA051102208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA10059248OtherAMERIGROUP
GA52702956OtherBLUE CROSS AND BLUE SHIEL
GA000958691AMedicaid
GA000958691BMedicaid
GA020053562OtherRAIL ROAD MEDICARE
GA342054OtherWELLCARE
GA10059248OtherAMERIGROUP
GA020053562OtherRAIL ROAD MEDICARE
GA02BBGGVMedicare PIN