MEDICARE: RICHARD E WHITE PA-C

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	363A00000X	Physician Assistant	1082491

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528210655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD E WHITE PA-C

Provider Business Mailing Address
First Line	:	75 PRINTERS PKWY STE 200
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80910-3142
Country	:	US
Telephone Number	:	719-300-1122
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 PRINTERS PKWY STE 200
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80910-3142
Country	:	US
Telephone Number	:	719-300-8433
Fax Number	:	719-300-7796

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

Provider Enumeration Date	:	10/21/2008
Last Update Date	:	02/11/2026

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Directions to “ RICHARD E WHITE PA-C” Practice Location

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