Individual
DR. JERRY CHAD WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
17700 E 39TH ST S, INDEPENDENCE, MO 64055-6725
(816) 393-0250
Mailing address
17700 E 39TH ST S, INDEPENDENCE, MO 64055-6725
(816) 393-0250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2007001654
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204481402
—
MO
Enumeration date
05/23/2007
Last updated
03/29/2022
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