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NPI 1790632727

NPI 1790632727 : ROBERT WHITE PARAMEDIC : LAVONIA, GA

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General NPI Number Information
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    NPI Number           |    1790632727
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    Entity Type          |    Individual 
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    Provider Name        |    ROBERT WHITE PARAMEDIC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/10/2026
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    Last Update Date     |    03/10/2026
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Provider Practice Location Address
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    Address Line         |    305 BOWMAN ST 
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    City                 |    LAVONIA
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    State                |    GA
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    Zip                  |    30553-1404
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    Country              |    US
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    Telephone            |    706-491-3171
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    305 BOWMAN ST 
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    City                 |    LAVONIA
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    State                |    GA
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    Zip                  |    30553-1404
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    146L00000X
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    Taxonomy Name        |    Paramedic
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    License Number       |    P024412
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    License Number State |    GA
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