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General NPI Number Information
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NPI Number | 1124279492
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Entity Type | Organization
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Legal Business Name | BENJAMIN A WHITE, DO., LLC
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Dates
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Enumeration Date | 10/06/2008
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Last Update Date | 10/06/2008
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Provider Practice Location Address
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Address Line | 513 SUPERIOR ST
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City | ROSSFORD
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State | OH
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Zip | 43460-1246
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Country | US
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Telephone | 419-666-5202
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Fax | 419-666-7081
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Provider Business Mailing Address
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Address Line | 513 SUPERIOR ST
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City | ROSSFORD
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State | OH
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Zip | 43460-1246
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Country | US
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Telephone | 419-666-5202
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Fax | 419-666-7081
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Authorized Official
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Title or Position | OWNER
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Name | BENJAMIN A WHITE
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Credential | 4196665202
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Telephone | 419-666-5202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 34.007296
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License Number State | OH
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