Healthcare Provider Details

I. General information

NPI: 1942288071
Provider Name (Legal Business Name): KEVIN MICHAEL WHITE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 N CAMPBELL AVE BLDG 2
TUCSON AZ
85719-1454
US

IV. Provider business mailing address

PO BOX 65780
TUCSON AZ
85728-5780
US

V. Phone/Fax

Practice location:
  • Phone: 520-694-8888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number74281
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: