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General NPI Number Information
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NPI Number | 1992850374
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Entity Type | Organization
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Legal Business Name | R. S. WHITE III, M.D., L.L.C.
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 461 COOK ST SUITE B
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City | ROYSTON
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State | GA
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Zip | 30662-4003
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Country | US
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Telephone | 706-245-1877
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Fax | 706-245-1433
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Provider Business Mailing Address
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Address Line | 461 COOK ST SUITE B
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City | ROYSTON
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State | GA
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Zip | 30662-4003
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Country | US
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Telephone | 706-245-1877
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Fax | 706-245-1433
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Authorized Official
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Title or Position | OWNER
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Name | RICHARD S WHITE III
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Credential | M.D.
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Telephone | 706-245-1877
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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 | 035788
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License Number State | GA
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