Individual
DR. JOHN WHITE DECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
253 COUNTY ROUTE 47, SARANAC LAKE, NY 12983-5403
(518) 891-0563
(518) 897-2700
Mailing address
221 COREYS RD, TUPPER LAKE, NY 12986-7723
(518) 891-0563
(518) 897-2700
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
156843
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000490110003
BLUE SHIELD OF NORTHEASTE
NY
05
—
00811096
—
NY
01
—
049001
MVP
NY
01
—
331066683
EMPIRE PLAN
NY
01
—
33106683
EXCELLUS
NY
01
—
7M5621
EMPIRE
NY
01
—
P0018406
RR MEDICARE
NY
Enumeration date
01/30/2006
Last updated
10/12/2012
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