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NPI Code Detail

MEDICARE: MELISSA ANN WHITE MD

MEDICARE: MELISSA ANN WHITE MD
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
1208000000XPediatrics PhysicianE-14035AR
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1104320225
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA ANN WHITE MD
Provider Business Mailing Address
First Line : 1 CHILDRENS WAY # 664
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72202-3500
Country : US
Telephone Number : 501-364-1100
Fax Number : 501-978-6436
Provider Business Practice Location Address
First Line : 1 CHILDRENS WAY # 512-19B
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72202-3500
Country : US
Telephone Number : 501-364-1100
Fax Number : 501-364-4082
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2018
Last Update Date : 06/18/2026

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