Individual
DR. TY A WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 E 26TH ST, SIOUX FALLS, SD 57105-4023
(605) 338-7098
(605) 335-3505
Mailing address
3908 S PILLSBERRY AVE, SIOUX FALLS, SD 57103-7273
(605) 331-0662
(605) 335-3505
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
5204
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150L5WH
BLUE CROSS MN
MN
05
—
163453400
—
MN
05
—
46041879113
—
NE
01
—
4996133
BLUE CROSS SD
SD
05
—
567719
—
IA
05
—
5701090
—
SD
Enumeration date
11/13/2006
Last updated
09/01/2009
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