Individual
JOHN B WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1620 E 12TH ST, TULSA, OK 74120-5407
(918) 357-5859
(918) 357-5859
Mailing address
PO BOX 140156, BROKEN ARROW, OK 74014
(918) 357-5859
(918) 357-5859
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
16315
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100200630A
—
OK
01
—
800522425
MEDICARE GRP#
OK
Enumeration date
06/09/2006
Last updated
01/07/2013
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