Provider Demographics
NPI:1306585617
Name:WHITE COUNTY GOVERNMENT
Entity type:Organization
Organization Name:WHITE COUNTY GOVERNMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:TRIBBETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:574-583-4025
Mailing Address - Street 1:PO BOX 838
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:IN
Mailing Address - Zip Code:47960-3201
Mailing Address - Country:US
Mailing Address - Phone:574-583-8254
Mailing Address - Fax:574-583-1513
Practice Address - Street 1:902 FOXWOOD COURT
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:IN
Practice Address - Zip Code:47960-3201
Practice Address - Country:US
Practice Address - Phone:574-583-8254
Practice Address - Fax:574-583-1513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty