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1831184175

NPI Code Detail

MEDICARE: DR. THOMAS WILLIAM WHITE MD

MEDICARE: DR. THOMAS WILLIAM 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
1	208600000X	Surgery Physician	19071	NE
2	2086S0102X	Surgical Critical Care Physician	175403-1205	UT

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	:	1831184175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS WILLIAM WHITE MD

Provider Business Mailing Address
First Line	:	PO BOX 27128
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84127-0128
Country	:	US
Telephone Number	:	801-507-3462
Fax Number	:

Provider Business Practice Location Address
First Line	:	5121 S COTTONWOOD ST
Second Line	:	SUITE 400
City	:	MURRAY
State	:	UT
Zip	:	84107-5701
Country	:	US
Telephone Number	:	801-507-3462
Fax Number	:

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

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	01/12/2015

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Directions to “ DR. THOMAS WILLIAM WHITE MD” Practice Location

Language	Start Address	Practice Location

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