MEDICARE: PHILLIP ALLEN 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
1	2084N0400X	Neurology Physician	35-07-6474-W	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00031539	OTHER	OH	MEDICARE RR

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	:	1740255975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILLIP ALLEN WHITE M.D.

Provider Business Mailing Address
First Line	:	3200 BURNET AVE
Second Line	:	3 SOUTH
City	:	CINCINNATI
State	:	OH
Zip	:	45229-3019
Country	:	US
Telephone Number	:	513-585-5503
Fax Number	:	513-475-8033

Provider Business Practice Location Address
First Line	:	7700 UNIVERSITY CT
Second Line	:	SUITE 3500
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-6542
Country	:	US
Telephone Number	:	513-475-8730
Fax Number	:	513-475-8273

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

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	01/03/2013

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Directions to “ PHILLIP ALLEN WHITE M.D.” Practice Location

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