Individual
JONATHON W WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
305 W JACKSON ST, SUITE 200, CARBONDALE, IL 62901-1474
(618) 536-6621
Mailing address
301 S ORANGE ST, JONESBORO, IL 62952-1104
(618) 833-1691
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125060525
IL
Other
Enumeration date
05/10/2012
Last updated
02/06/2015
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