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NPI Code Detail

MEDICARE: ABIGAIL S WHITE MD

MEDICARE:   ABIGAIL S 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
1208600000XSurgery Physician036138713IL

General Provider Information

NPI Number : 1144455767
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABIGAIL S WHITE MD
Provider Business Mailing Address
First Line : 1025 S 6TH ST
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62703-2403
Country : US
Telephone Number : 217-528-7541
Fax Number : 217-528-8962
Provider Business Practice Location Address
First Line : 15 FOUNDERS LN
Second Line :
City : JACKSONVILLE
State : IL
Zip : 62650-3919
Country : US
Telephone Number : 217-528-7541
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2009
Last Update Date : 05/19/2020

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Directions to “ ABIGAIL S WHITE MD” Practice Location

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