Provider Demographics
NPI:1760777577
Name:WHITAKER, GRAHAM THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:GRAHAM
Middle Name:THOMAS
Last Name:WHITAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1405 CENTERVILLE RD
Mailing Address - Street 2:SUITE 5400
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4655
Mailing Address - Country:US
Mailing Address - Phone:850-877-0101
Mailing Address - Fax:850-877-2750
Practice Address - Street 1:1405 CENTERVILLE RD
Practice Address - Street 2:SUITE 5400
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4655
Practice Address - Country:US
Practice Address - Phone:850-877-0101
Practice Address - Fax:850-877-2750
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLTRN16134207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology