MEDICARE: DR. MALLORY JOAN 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
1	225X00000X	Occupational Therapist	6219	OK

General Provider Information

NPI Number	:	1093667917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MALLORY JOAN WHITE

Provider Business Mailing Address
First Line	:	2230 SE WASHINGTON BLVD STE 4
Second Line	:
City	:	BARTLESVILLE
State	:	OK
Zip	:	74006-7100
Country	:	US
Telephone Number	:	918-553-1122
Fax Number	:	833-840-6360

Provider Business Practice Location Address
First Line	:	2230 SE WASHINGTON BLVD STE 4
Second Line	:
City	:	BARTLESVILLE
State	:	OK
Zip	:	74006-7100
Country	:	US
Telephone Number	:	918-553-1122
Fax Number	:	833-840-6360

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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Directions to “ DR. MALLORY JOAN WHITE ” Practice Location

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