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Individual

JAY W. WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
101 E MINNESOTA ST, SUITE 210, RAPID CITY, SD 57701-7756
(605) 342-3280
(605) 721-8458
Mailing address
2820 MOUNT RUSHMORE RD, RAPID CITY, SD 57701-5462
(605) 342-3280
(605) 721-8458

Taxonomy

Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
34007897
OH
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
5101013470
MI
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
7612
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2338947
OH
05
6632340
SD
Enumeration date
07/20/2005
Last updated
05/18/2012
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