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Individual

DR. JOHN BOWMAN WHITE III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
3860 TEAYS VALLEY RD, SUITE 1, HURRICANE, WV 25526-9772
(304) 757-5880
(304) 757-5881
Mailing address
3860 TEAYS VALLEY RD, SUITE 1, HURRICANE, WV 25526-9772
(304) 757-5880
(304) 757-5881

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
00313
WV
213ES0000X
Sports Medicine Podiatrist
00313
WV
213ES0103X
Foot & Ankle Surgery Podiatrist
00313
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0099970000
WV
Enumeration date
09/23/2005
Last updated
03/17/2011
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