Individual
MICHAEL WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
100 HOSPITAL DR, LEBANON, MO 65536-9210
(417) 533-6100
Mailing address
800 STATE HIGHWAY 248 STE 2E, BRANSON, MO 65616-4078
(417) 553-1197
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2022008548
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194283
NCCPA
—
Enumeration date
03/09/2022
Last updated
10/03/2023
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