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General NPI Number Information
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NPI Number | 1821042441
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Entity Type | Individual
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Provider Name | BRUCE DAVID WHITE DO
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Gender | Male
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 124 W THOMAS RD SUITE 240
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City | PHOENIX
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State | AZ
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Zip | 85013-4405
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Country | US
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Telephone | 602-406-5199
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Fax |
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Provider Business Mailing Address
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Address Line | 3200 N CENTRAL AVE ST. 900
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City | PHOENIX
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State | AZ
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Zip | 85012-2425
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Country | US
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Telephone | 602-406-3729
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Fax | 602-798-9412
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 3997
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License Number State | AZ
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