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NPI Code Detail

MEDICARE: ADAM CARY WHITE

MEDICARE: ADAM CARY WHITE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer SpecialistOK

General Provider Information

NPI Number : 1003643636
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADAM CARY WHITE
Provider Business Mailing Address
First Line : 2412 N ANN ARBOR AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73127-1811
Country : US
Telephone Number : 405-248-6202
Fax Number :
Provider Business Practice Location Address
First Line : 2412 N ANN ARBOR AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73127-1811
Country : US
Telephone Number : 405-248-6202
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2024
Last Update Date : 09/17/2024

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Directions to “ ADAM CARY WHITE ” Practice Location

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