Individual
MR. JOSHUA JOHN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1818 N MEADE ST, APPLETON, WI 54911-3454
(920) 731-8900
(920) 225-1479
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
(920) 738-4780
(920) 738-5787
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
3618
GA
363AM0700X
Medical Physician Assistant
Primary
2096
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100002112A
—
GA
05
—
41937200
—
WI
01
—
450030728
MEDICARE PTAN
WI
01
—
711290124
MEDICARE PTAN
WI
01
—
WI2257002
MEDICARE PTAN
WI
Enumeration date
04/26/2006
Last updated
02/02/2015
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