Healthcare Provider Details

I. General information

NPI: 1619553526
Provider Name (Legal Business Name): GRANT HARRISON WHITE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2021
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 SW 7TH ST
TOPEKA KS
66606-2489
US

IV. Provider business mailing address

1700 SW 7TH ST
TOPEKA KS
66606-2489
US

V. Phone/Fax

Practice location:
  • Phone: 785-295-8000
  • Fax:
Mailing address:
  • Phone: 785-295-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number05-50356
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: