Provider Demographics
NPI:1063754596
Name:WHITE, RYAN CHRISTIAN (MD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:CHRISTIAN
Last Name:WHITE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 GAUSE BLVD
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2840
Mailing Address - Country:US
Mailing Address - Phone:318-709-9616
Mailing Address - Fax:
Practice Address - Street 1:736 GAUSE BLVD
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2840
Practice Address - Country:US
Practice Address - Phone:318-709-9616
Practice Address - Fax:910-240-9710
Is Sole Proprietor?:No
Enumeration Date:2013-03-22
Last Update Date:2025-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207713208M00000X
LAMD.207713207Q00000X, 207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program