# GREENBRIER VALLEY ENT PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467524082
- **Authorized official:** MR. CHRISTOPHER LEE WHITE D.O. (OWNER PHYSICIAN)
- **Authorized official phone:** (304) 645-0870

## Contact information

- **Practice address:** 118 TAYLOR LN, RONCEVERTE, WV 24970-1337
- **Practice address phone:** (304) 520-4991
- **Mailing address:** PO BOX 902, LEWISBURG, WV 24901-0902
- **Mailing address phone:** (304) 520-4991

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YS0123X | Facial Plastic Surgery Physician | — | NULL | Yes |
| 207YS0123X | Facial Plastic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/15/2006
- **Last updated:** 03/17/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 001916386 | MTN ST BCBS | WV |
| 01 | — | 1071033 | BRICK STREET W/COMP | — |
| 05 | — | 129458 | — | WV |
| 01 | — | 1306817689 | UNISYS | WV |
| 01 | — | 611994100 | FEDERAL BLACK LUNG | — |
| 01 | — | 7786898 | AETNA | — |