Healthcare Provider Details

I. General information

NPI: 1871172452
Provider Name (Legal Business Name): JOHN WHITE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2021
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 FISHER ST
BILOXI MS
39534-2508
US

IV. Provider business mailing address

301 FISHER ST
KEESLER AFB MS
39534-2508
US

V. Phone/Fax

Practice location:
  • Phone: 228-376-2273
  • Fax:
Mailing address:
  • Phone: 228-376-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number37326
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: