| Stephen A. White, M.d., P.c. | |
|
2289 B Rudolphtown Road Clarksville TN 37043-4539 | |
| (931) 552-3031 | |
| (931) 552-9820 |
| Full Name | Stephen A. White, M.d., P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2289 B Rudolphtown Road, Clarksville, Tennessee |
| Authorized Official Name and Position | Stephen A White (PRESIDENT) |
| Authorized Official Contact | 9315523031 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephen A. White, M.d., P.c. 2289 B Rudolphtown Road Clarksville TN 37043-4539 Ph: (931) 552-3031 | Stephen A. White, M.d., P.c. 2289 B Rudolphtown Road Clarksville TN 37043-4539 Ph: (931) 552-3031 |
| NPI Number | 1114946290 |
|---|---|
| Provider Enumeration Date | 07/19/2006 |
| Last Update Date | 05/24/2012 |
| Medicare PECOS PAC ID | 2466592167 |
|---|---|
| Medicare Enrollment ID | O20091210000305 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114946290 | NPI | - | NPPES |
| 3153602 | Other | TN | BLUE CROSS |
| 3721373 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD14198 (Tennessee) | Primary |
| Provider Name | Stephen A White |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740487305 PECOS PAC ID: 0042288532 Enrollment ID: I20040924000544 |
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