Provider Demographics
NPI:1811187388
Name:WHITLING, CHELSEE LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHELSEE
Middle Name:LYNN
Last Name:WHITLING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:81 UPPER RIVERDALE ROAD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274
Mailing Address - Country:US
Mailing Address - Phone:770-996-1200
Mailing Address - Fax:770-907-5279
Practice Address - Street 1:81 UPPER RIVERDALE ROAD
Practice Address - Street 2:SUITE 210
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274
Practice Address - Country:US
Practice Address - Phone:770-996-1200
Practice Address - Fax:770-907-5279
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAGETP.LSU.OBG207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1007650Medicaid