Healthcare Provider Details

I. General information

NPI: 1114922473
Provider Name (Legal Business Name): JAMES EUGENE WHITE M.D., F.A.C.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 11/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7446 SHALLOWFORD RD SUITE 205
CHATTANOOGA TN
37421-8815
US

IV. Provider business mailing address

7446 SHALLOWFORD RD SUITE 205
CHATTANOOGA TN
37421-8815
US

V. Phone/Fax

Practice location:
  • Phone: 423-648-4011
  • Fax: 423-648-4014
Mailing address:
  • Phone: 423-648-4011
  • Fax: 423-648-4014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number023447
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: