Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 25MB08382200 | NJ |
NPI | 1740485887 |
---|---|
Provider Name | Dr. Kevin S. White |
First Address | Hackettstow, NJ 07840 |
Second Address | Hackettstown, NJ 07840 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2007 |
Last Update Date | 30/01/2014 |