Healthcare Provider Details

I. General information

NPI: 1205820925
Provider Name (Legal Business Name): JOHN EDWARD WHITE JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2005
Last Update Date: 03/22/2022
Certification Date: 03/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8350 E KEMPER RD STE A
CINCINNATI OH
45249-1684
US

IV. Provider business mailing address

8350 E KEMPER RD STE A
CINCINNATI OH
45249-1684
US

V. Phone/Fax

Practice location:
  • Phone: 513-404-4166
  • Fax:
Mailing address:
  • Phone: 513-404-4166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35056826W
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: