Individual
DR. WHITE SOLOMON GRAVES IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1501 LOUISVILLE AVE, MONROE, LA 71201-6025
(318) 323-8451
(318) 361-2613
Mailing address
1501 LOUISVILLE AVE, MONROE, LA 71201-6025
(318) 323-8451
(318) 361-2613
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
14205R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1107131
—
LA
Enumeration date
12/14/2005
Last updated
01/10/2014
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