Individual
MR. SAMUEL WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
950 MATTHEW DR, WAYNESBORO, MS 39367-2567
(601) 735-7101
(601) 735-7181
Mailing address
950 MATTHEW DR, WAYNESBORO, MS 39367-2590
(601) 735-7101
(601) 735-7181
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R860585
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02672767
—
MS
Enumeration date
06/06/2006
Last updated
07/23/2024
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