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General NPI Number Information
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NPI Number | 1497852610
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Entity Type | Organization
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Legal Business Name | JOHN ANTHONY WHITE,M.D.,P.A.
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/21/2009
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Provider Practice Location Address
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Address Line | 533 N CLYDE MORRIS BLVD STE A
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-2323
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Country | US
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Telephone | 386-255-0909
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Fax | 386-255-4454
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Provider Business Mailing Address
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Address Line | 533 N CLYDE MORRIS BLVD STE A
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-2323
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Country | US
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Telephone | 386-255-0909
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Fax | 386-255-4454
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Authorized Official
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Title or Position | NURSE
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Name | MS. HELEN M TIPLADY
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Credential | LPN
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Telephone | 386-255-0901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME0039128
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License Number State | FL
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