Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | MD0000017977 | TN |
NPI | 1003918897 |
---|---|
Provider Name | Gregory P White |
First Address | Chattanooga, TN 37424-8389 |
Second Address | Chattanooga, TN 37421-6708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2006 |
Last Update Date | 03/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3095022 | CIGNA MEDICARE OF TN (01) | TN |
3095022 | TENNCARE/MEDICAID (01) | TN |
4063781 | BC/BS OF TN (01) | TN |
4063781 | TENNCARE SELECT (01) | TN |
621613625001 | TRICARE SOUTHERN REGION (01) | TN |
G19483 | UPIN (01) | TN |
P00081775 | RR MEDICARE (01) | TN |
TN0102 | JOHN DEERE HEALTH (01) | TN |