| White Family Practice Clinic | |
|
302 East Fifth Street White SD 57276 | |
| (605) 629-8211 | |
| (605) 629-8291 |
| Full Name | White Family Practice Clinic |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 302 East Fifth Street, White, South Dakota |
| Authorized Official Name and Position | Jeff Gollaher (CEO) |
| Authorized Official Contact | 5072753134 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| White Family Practice Clinic Po Box 106 Hendricks MN 56136-0106 Ph: (507) 275-3134 | White Family Practice Clinic 302 East Fifth Street White SD 57276 Ph: (605) 629-8211 |
| NPI Number | 1790863405 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790863405 | NPI | - | NPPES |
| 5306792 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 11137 (South Dakota) | Primary |
Brookings Health System White Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 302 E 5th Street, White, SD 57276 Phone: 605-696-9000 Fax: 605-696-7751 |