Individual
JERRY RAY WHITE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
613 23RD ST STE 230, ASHLAND, KY 41101-2868
(606) 324-4745
(606) 324-4941
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 408-9571
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
TP372
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0416565
—
OH
05
—
7100677090
—
KY
Enumeration date
03/04/2014
Last updated
03/25/2021
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