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General NPI Number Information
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NPI Number | 1417094244
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Entity Type | Organization
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Legal Business Name | ELIZABETH B WHITE MD INC
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 09/24/2008
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Provider Practice Location Address
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Address Line | 205 HIGHLAND PARK PLZ
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City | COVINGTON
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State | LA
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Zip | 70433-7130
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Country | US
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Telephone | 985-871-8681
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Fax | 985-871-8684
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Provider Business Mailing Address
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Address Line | 205 HIGHLAND PARK PLZ
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City | COVINGTON
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State | LA
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Zip | 70433-7130
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Country | US
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Telephone | 985-871-8681
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Fax | 985-871-8684
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Authorized Official
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Title or Position | OWNER
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Name | DR. ELIZABETH B WHITE
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Credential | MD
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Telephone | 985-871-8681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 09381R
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 09381R
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License Number State | LA
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