Provider Demographics
NPI:1992812887
Name:WHEELOCK, HARRY B JR (PA)
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:B
Last Name:WHEELOCK
Suffix:JR
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 MEDICAL PARK DR E
Mailing Address - Street 2:SUITE 255
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3400
Mailing Address - Country:US
Mailing Address - Phone:205-838-3090
Mailing Address - Fax:205-838-6783
Practice Address - Street 1:48 MEDICAL PARK DR E
Practice Address - Street 2:SUITE 255
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3400
Practice Address - Country:US
Practice Address - Phone:205-838-3090
Practice Address - Fax:205-838-6783
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA-57207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL09939211Medicaid
051537663Medicare PIN