Individual
DR. STACY ALLAN WHITE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
807 CHILDRENS WAY, JACKSONVILLE, FL 32207-8426
(904) 697-3694
(904) 697-3927
Mailing address
10140 CENTURION PKWY N, JACKSONVILLE, FL 32256-0532
(904) 697-4127
(904) 697-5102
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
MD465719
PA
2085P0229X
Pediatric Radiology Physician
Primary
ME144263
FL
Other
Enumeration date
06/20/2013
Last updated
08/03/2022
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