Provider Demographics
NPI:1013507680
Name:WHITFIELD FAMILY PRACTICE LLC
Entity Type:Organization
Organization Name:WHITFIELD FAMILY PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:JOHNSON
Authorized Official - Last Name:WHITFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-686-3456
Mailing Address - Street 1:2828 HIGHWAY 31 S STE 111
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35603-1538
Mailing Address - Country:US
Mailing Address - Phone:256-686-3456
Mailing Address - Fax:256-686-3519
Practice Address - Street 1:2828 HIGHWAY 31 S STE 111
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-1538
Practice Address - Country:US
Practice Address - Phone:256-686-3456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-19
Last Update Date:2023-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty