Whitney, Edwin Glenn

Whitney, Edwin Glenn is an individual health care provider with primary practice located at 157 Clinic Ave Suite 302, Carrollton GA 30117-4454. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Whitney, Edwin Glenn can be contacted via phone (770) 812-5902.

Contact Information

Primary practice address
157 Clinic Ave Suite 302 Carrollton GA 30117-4454
Phone: (770) 812-5902
Fax: (770) 812-5903
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 044604 Georgia

Profile Details

NPI number 1992860985
LBN Legal business name Whitney, Edwin Glenn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2006
Last updated Mar 14th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992860985 NPPES
Georgia MEDICAID 000841079B
Georgia MEDICAID 000841079D
Georgia MEDICAID 000841079I
Georgia MEDICAID 000841079C

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