Provider Demographics
NPI:1962523662
Name:WHITTINGTON, KOURI & GENTRY, P.C.
Entity type:Organization
Organization Name:WHITTINGTON, KOURI & GENTRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-263-3630
Mailing Address - Street 1:1758 PARK PL
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-1127
Mailing Address - Country:US
Mailing Address - Phone:334-263-3630
Mailing Address - Fax:334-263-3155
Practice Address - Street 1:1758 PARK PL
Practice Address - Street 2:SUITE 201
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1127
Practice Address - Country:US
Practice Address - Phone:334-263-3630
Practice Address - Fax:334-263-3155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13727173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000036120Medicaid
AL000037369Medicaid
AL51036120WHIMedicare ID - Type UnspecifiedF. KIM WHITTINGTON, MD
AL51037369KOUMedicare ID - Type UnspecifiedDAVID L. KOURI, MD