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General NPI Number Information
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NPI Number | 1093723496
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Entity Type | Individual
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Provider Name | ROBERT L WHITE JR. MD
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Gender | Male
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 02/25/2021
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Provider Practice Location Address
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Address Line | 5550 S EAST ST STE C
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City | INDIANAPOLIS
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State | IN
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Zip | 46227-1991
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Country | US
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Telephone | 317-780-4080
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Fax |
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Provider Business Mailing Address
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Address Line | 1425 VALLEY VIEW DR
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City | JASPER
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State | IN
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Zip | 47546-1870
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Country | US
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Telephone | 812-634-5014
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 01043583A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number | 01043583A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | 01043583A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 35.090717
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License Number State | OH
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