Whitley, John Calvin
Whitley, John Calvin is an sole proprietor health care provider with primary practice located at 2828 Hillcreek Dr , Augusta GA 30909-5628. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Whitley, John Calvin can be contacted via phone (706) 228-5006.Contact Information
Primary practice address
2828 Hillcreek Dr
Augusta GA 30909-5628
Phone: (706) 228-5006
Fax: (706) 228-1848
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 1922 | Georgia |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 625 | South Carolina |
Profile Details
| NPI number | 1184607483 |
|---|---|
| LBN Legal business name | Whitley, John Calvin |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 21st, 2005 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184607483 | NPPES |
| South Carolina | Other | PSO207 | MEDICAID |
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