Allan Whitney, SUB IDC

Individual provider Active NPI Independent Duty Corpsman · Kings Bay, GA

NPI 1962834531 · NPPES record last updated Feb 25, 2025

Key facts

NPI
1962834531
Entity type
Individual (NPI type 1)
Primary specialty
Independent Duty Corpsman 1710I1002X
Practice address
881 Uss James Madison Rd
Kings Bay, GA 31547-2531
Phone
(817) 648-9250
NPI assigned
Aug 6, 2013
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X Yes

Addresses

Primary practice location

881 Uss James Madison Rd
Kings Bay, GA 31547-2531

Mailing address

881 Uss James Madison Rd
Kings Bay, GA 31547-2531
Phone (912) 573-6548

Other providers in Kings Bay, GA

All providers in Kings Bay, GA · Independent Duty Corpsman in Georgia

Sources for this page

Verify at the official NPI Registry.