MEDICARE: KEVIN MICHAEL 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	207K00000X	Allergy & Immunology Physician	74281	AZ

General Provider Information

NPI Number	:	1942288071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN MICHAEL WHITE MD

Provider Business Mailing Address
First Line	:	PO BOX 65780
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85728-5780
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3838 N CAMPBELL AVE BLDG 2
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85719-1454
Country	:	US
Telephone Number	:	520-694-8888
Fax Number	:

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

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	04/30/2025

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