Individual
MR. WILLIAM A. WHITE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
501 MORRIS ST, CHARLESTON, WV 25301-1326
(304) 388-9954
(304) 388-9955
Mailing address
3110 MACCORKLE AVE SE, RM 2041, CHARLESTON, WV 25304-1210
(304) 369-1456
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN26801-CRNA
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0065280000
—
WV
01
—
430070103
MEDICARE RAILROAD
WV
Enumeration date
11/01/2006
Last updated
05/03/2017
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