=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104206366
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRITTANY WHITE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/03/2015
-----------------------------------------------------
Last Update Date | 11/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 655 7TH ST BLDG 700
-----------------------------------------------------
City | ROBINS AFB
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31098-2227
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 478-926-9933
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 655 7TH ST BLDG 700
-----------------------------------------------------
City | ROBINS AFB
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31098-2227
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 478-327-7850
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2083X0100X
-----------------------------------------------------
Taxonomy Name | Occupational Medicine Physician
-----------------------------------------------------
License Number | 02004923A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number | 02004923A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------