Whittaker, Grant Tyler

Whittaker, Grant Tyler is an individual health care provider with primary practice located at 1348 South 18Th Street Suite 100, Fernandina Beach FL 32034-4755. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Whittaker, Grant Tyler can be contacted via phone (904) 261-0879.

Contact Information

Primary practice address
1348 South 18Th Street Suite 100 Fernandina Beach FL 32034-4755
Phone: (904) 261-0879
Fax: (904) 277-7054
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD 30868 Alabama
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME 105816 Florida
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X ME105816 Florida

Profile Details

NPI number 1073710992
LBN Legal business name Whittaker, Grant Tyler
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2007
Last updated Aug 27th, 2014 - about 12 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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