Provider Demographics
NPI:1487397865
Name:WHISBY HEALTH LLLP
Entity type:Organization
Organization Name:WHISBY HEALTH LLLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:WHISBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-208-3573
Mailing Address - Street 1:767 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-2232
Mailing Address - Country:US
Mailing Address - Phone:678-208-3573
Mailing Address - Fax:678-208-3573
Practice Address - Street 1:767 NORTH AVE
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-2232
Practice Address - Country:US
Practice Address - Phone:678-208-3573
Practice Address - Fax:678-208-3573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty