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General NPI Number Information
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NPI Number | 1083744908
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Entity Type | Individual
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Provider Name | WILLIAM C WHITE OD
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Gender | Male
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 815 SHUGART RD WALMART VISION
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City | DALTON
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State | GA
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Zip | 30721
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Country | US
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Telephone | 706-272-7193
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Fax | 706-272-7165
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Provider Business Mailing Address
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Address Line | 1962 HOWELL BRIDGE RD
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City | BALL GROUND
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State | GA
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Zip | 30107
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Country | US
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Telephone | 770-735-4437
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Fax | 706-272-7165
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT000934
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License Number State | GA
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