Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 10080A | WY |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 10080A | WY |
NPI | 1154375905 |
---|---|
Provider Name | Dr. Daniel W. White |
First Address | Casper, WY 82609-3265 |
Second Address | Casper, WY 82609-3265 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 03/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10080A | WY LICENSE (01) | WY |