| Elizabeth B White Md Inc | |
|
205 Highland Park Plz Covington LA 70433-7130 | |
| (985) 871-8681 | |
| (985) 871-8684 |
| Full Name | Elizabeth B White Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 205 Highland Park Plz, Covington, Louisiana |
| Authorized Official Name and Position | Elizabeth B White (OWNER) |
| Authorized Official Contact | 9858718681 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elizabeth B White Md Inc 205 Highland Park Plz Covington LA 70433-7130 Ph: (985) 871-8681 | Elizabeth B White Md Inc 205 Highland Park Plz Covington LA 70433-7130 Ph: (985) 871-8681 |
| NPI Number | 1417094244 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 09/24/2008 |
| Medicare PECOS PAC ID | 6507872611 |
|---|---|
| Medicare Enrollment ID | O20060228000024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417094244 | NPI | - | NPPES |
| 5R802CT69 | Other | LA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 09381R (Louisiana) | Primary |
| 208000000X | Pediatrics | 09381R (Louisiana) | Secondary |
| Provider Name | Elizabeth B White |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184604399 PECOS PAC ID: 9234145343 Enrollment ID: I20060301000034 |
| Provider Name | Shirley J Timmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093090235 PECOS PAC ID: 3173799533 Enrollment ID: I20120105000983 |
| Provider Name | Pamela Blundell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194080333 PECOS PAC ID: 0446409700 Enrollment ID: I20121001000271 |
| Provider Name | Josephine E Sims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023430725 PECOS PAC ID: 8921231838 Enrollment ID: I20140430000743 |
| Provider Name | Cassie A Guste |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063813681 PECOS PAC ID: 1759603566 Enrollment ID: I20141205001613 |
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