Individual
DR. RONALD LYNN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1611 W MAIN ST, RUSSELLVILLE, AR 72801-2719
(479) 890-5881
(479) 890-5092
Mailing address
1611 W MAIN ST, RUSSELLVILLE, AR 72801-2719
(479) 890-5881
(479) 890-5092
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C6004
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112265001
—
AR
01
—
5F920
PTAN
AR
Enumeration date
08/20/2006
Last updated
01/22/2015
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