Provider Demographics
NPI:1942306824
Name:WHITNEY, STANLEY J (MD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:J
Last Name:WHITNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2868 MAHAN DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5468
Mailing Address - Country:US
Mailing Address - Phone:850-942-7177
Mailing Address - Fax:850-656-9443
Practice Address - Street 1:2868 MAHAN DR
Practice Address - Street 2:SUITE 5
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5468
Practice Address - Country:US
Practice Address - Phone:850-942-7177
Practice Address - Fax:850-656-9443
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME708542084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE34777Medicare UPIN