Provider Demographics
NPI:1720177082
Name:WHITTLE, JOHN PARROTT JR (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:PARROTT
Last Name:WHITTLE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 SWEETBRIAR CIR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2050
Mailing Address - Country:US
Mailing Address - Phone:912-657-6058
Mailing Address - Fax:912-350-5697
Practice Address - Street 1:1220 SWEETBRIAR CIR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2050
Practice Address - Country:US
Practice Address - Phone:912-657-6058
Practice Address - Fax:912-257-4564
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC280972080P0207X
GA0613752080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA470250OtherWELLCARE
GA984553715CMedicaid
01258484OtherAMERIGROUP
GAP00649629OtherRAILROAD MEDICARE
SCP00915506OtherRAILROAD MEDICARE
GA984553715AMedicaid
GA984553715BMedicaid
GA984553715DMedicaid
SCG61375Medicaid
GA984553715DMedicaid
GA511I830020Medicare PIN