Healthcare Provider Details

I. General information

NPI: 1386141521
Provider Name (Legal Business Name): ANTHONY MICHAEL WHITE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2018
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4508 38TH ST STE 133
COLUMBUS NE
68601-1668
US

IV. Provider business mailing address

4508 38TH ST STE 133
COLUMBUS NE
68601-1668
US

V. Phone/Fax

Practice location:
  • Phone: 402-603-6840
  • Fax:
Mailing address:
  • Phone: 402-562-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number69510
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number36119
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: