Individual
JASON WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2864 WOODRUFF STREET, FORT LIBERTY, NC 28302
(330) 425-7133
Mailing address
166 NATIONAL DR, PINEHURST, NC 28374-8165
(910) 215-0984
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34007870
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2485949
—
OH
Enumeration date
08/16/2005
Last updated
01/10/2024
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