Provider Demographics
NPI:1215147418
Name:JOHN S.WHITE,M.D.
Entity type:Organization
Organization Name:JOHN S.WHITE,M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-763-4224
Mailing Address - Street 1:1521 N 10TH ST STE E
Mailing Address - Street 2:
Mailing Address - City:BLYTHEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72315-1424
Mailing Address - Country:US
Mailing Address - Phone:870-763-4224
Mailing Address - Fax:870-763-4325
Practice Address - Street 1:1521 N 10TH ST STE E
Practice Address - Street 2:
Practice Address - City:BLYTHEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72315-1424
Practice Address - Country:US
Practice Address - Phone:870-763-4224
Practice Address - Fax:870-763-4325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5K303Medicare ID - Type Unspecified