Provider Demographics
NPI:1104914514
Name:WHITE, JAMES OLIVER (PA)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:OLIVER
Last Name:WHITE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:US ARMY HOSPITAL HEIDELBERG
Mailing Address - Street 2:CMR 442 BOX 150
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09042
Mailing Address - Country:DE
Mailing Address - Phone:49622-117-3111
Mailing Address - Fax:
Practice Address - Street 1:US ARMY HOSPITAL HEIDELBERG
Practice Address - Street 2:CMR 442 BOX 150
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09042
Practice Address - Country:DE
Practice Address - Phone:49622-117-3111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1013037363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical