Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 009866 | LA |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 009866 | LA |
NPI | 1669471751 |
---|---|
Provider Name | James A White III |
First Address | Alexandria, LA 71301 |
Second Address | Alexandria, LA 71301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2005 |
Last Update Date | 16/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1125717 | (05) | LA |