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General NPI Number Information
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NPI Number | 1437111572
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Entity Type | Organization
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Legal Business Name | JAMES R. WHITE, DO PC
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Dates
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Enumeration Date | 04/04/2006
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Last Update Date | 07/19/2007
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Provider Practice Location Address
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Address Line | 1005 COLLEGE VIEW DR
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City | RIVERTON
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State | WY
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Zip | 82501-2266
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Country | US
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Telephone | 307-857-5234
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Fax | 307-857-5215
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Provider Business Mailing Address
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Address Line | 1005 COLLEGE VIEW DR
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City | RIVERTON
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State | WY
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Zip | 82501-2266
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Country | US
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Telephone | 307-857-5234
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Fax | 307-857-5215
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Authorized Official
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Title or Position | CEO
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Name | JAMES R WHITE
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Credential | DO
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Telephone | 307-857-5234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 651
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License Number State | MI
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