Individual
DR. JOHN MICHAEL WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
4416 ELIZABETH ST, TEXARKANA, TX 75503-2902
(903) 792-2121
(903) 793-6444
Mailing address
PO BOX 347, TEXARKANA, TX 75504-0347
(903) 792-2121
(903) 793-6444
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1221
TX
213E00000X
Podiatrist
134
AR
213E00000X
Podiatrist
181
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0187395-01
—
TX
01
—
0645790001
PALMETTO
TX
05
—
100779580A
—
OK
05
—
128645717
—
AR
01
—
154960716
MEDICAID DME
AR
01
—
480015333
RAILROAD MEDICARE
AR
01
—
480027525
RAILROAD MEDICARE
TX
Enumeration date
07/29/2005
Last updated
05/22/2012
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