Provider Demographics
NPI:1114716024
Name:WHITT, CARYLON FAY
Entity type:Individual
Prefix:
First Name:CARYLON
Middle Name:FAY
Last Name:WHITT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1514
Mailing Address - Country:US
Mailing Address - Phone:740-978-3856
Mailing Address - Fax:
Practice Address - Street 1:714 2ND AVE
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-1514
Practice Address - Country:US
Practice Address - Phone:740-978-3856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant