Individual
HORACE ROGER WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
49 S MARIETTA PKWY SW, #C, MARIETTA, GA 30064-3288
(770) 424-0647
(770) 590-5990
Mailing address
1660 CAVAN DR SW, MARIETTA, GA 30064-2942
(770) 424-1782
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16447
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00193223F
—
GA
01
—
110092128
RAIL ROAD MEDICARE
GA
01
—
1215001144
BLUE CROSS BLUE SHIELD
GA
01
—
124860510967
HUMANA
GA
01
—
4231143
AETNA
GA
01
—
582142384
TRICARE
GA
01
—
5986187
CIGNA
GA
Enumeration date
11/20/2006
Last updated
05/19/2008
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