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Individual

DR. LOUIS ELDEAN WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
1931 HORTON RD, SUITE 10, JACKSON, MI 49203-5594
(517) 788-8251
(517) 788-8704
Mailing address
1931 HORTON RD, SUITE 10, JACKSON, MI 49203-5594
(517) 788-8251
(517) 788-8704

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
5901000896
MI
213ES0131X
Foot Surgery Podiatrist
5901000896
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1336
HEALTH PLAN OF MICHIGAN
MI
05
2102153
MI
01
2728009
PHYSICIANS HEALTH PLAN
MI
01
4853851270
BCBSM
MI
Enumeration date
11/30/2006
Last updated
12/07/2007
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