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Organization

WHITE TANK MEDICAL PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JUSTIN JAMES WOODSIDE (OWNER)
(623) 583-9180
Entity
Organization

Contact information

Practice address
18761 N REEMS RD STE 400, SURPRISE, AZ 85374-8646
(623) 583-9180
Mailing address
18761 N REEMS RD STE 400, SURPRISE, AZ 85374-8646

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
03/23/2023
Last updated
03/23/2023
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