Individual
JEREMY RUSSELL WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
825 NE 10TH ST., SUITE 1300, OKLAHOMA CITY, OK 73104
(405) 271-2663
(405) 271-6762
Mailing address
920 STANTON L YOUNG BLVD, ROOM WP 1380, OKLAHOMA CITH, OK 73104
(405) 271-4426
(405) 271-3461
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
26943
OK
207X00000X
Orthopaedic Surgery Physician
47872
WI
Other
Enumeration date
06/13/2006
Last updated
04/20/2011
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