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NPI Code Detail

MEDICARE: LAURA P WHITE M.D.

MEDICARE: LAURA P WHITE M.D.
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 Physician28851KY

General Provider Information

NPI Number : 1558364299
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA P WHITE M.D.
Provider Business Mailing Address
First Line : 140 STONECREST RD
Second Line : SUITE 101
City : SHELBYVILLE
State : KY
Zip : 40065-8142
Country : US
Telephone Number : 502-633-6411
Fax Number : 502-633-6657
Provider Business Practice Location Address
First Line : 140 STONECREST RD
Second Line : STE 101
City : SHELBYVILLE
State : KY
Zip : 40065-8142
Country : US
Telephone Number : 502-633-6411
Fax Number : 502-633-6657
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2005
Last Update Date : 12/30/2008

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