Individual
DR. JEAN KING WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1717 OAK PARK BLVD FL 2, LAKE CHARLES, LA 70601-8990
(337) 494-3278
(337) 494-3240
Mailing address
PO BOX 122152 DEPT 2152, DALLAS, TX 75312-0001
(337) 494-2921
(337) 494-6523
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
MD.016890
LA
207RI0011X
Interventional Cardiology Physician
Primary
MD.016890
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1377970
—
LA
01
—
MD.016890
STATE MEDICAL LICENSE
LA
Enumeration date
09/20/2006
Last updated
04/27/2022
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