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Individual

DR. RODNEY L WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
901 12TH AVE S, NAMPA, ID 83651-4658
(208) 466-9251
(208) 463-1714
Mailing address
901 12TH AVE S, NAMPA, ID 83651-4658
(208) 466-9251
(208) 463-1714

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP 956
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010015540
REGENCY OF ID
ID
05
805221700
ID
01
V5467
BLUE CROSS OF ID
ID
Enumeration date
08/24/2005
Last updated
01/22/2013
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