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Individual

KEVIN S WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
101 MED TECH PKWY STE 100, JOHNSON CITY, TN 37604-4006
(423) 794-1800
(423) 794-1801
Mailing address
PO BOX 632476, CINCINNATI, OH 45263-2476
(423) 794-1800
(423) 794-1801

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4182
TN
363AM0700X
Medical Physician Assistant
4182
TN
363AS0400X
Surgical Physician Assistant
4182
TN

Other

Enumeration date
10/19/2020
Last updated
02/24/2025
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