Individual
DR. CHARLES WESLEY WHITE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
180 OLD HICKORY BLVD STE L, JACKSON, TN 38305-2500
(731) 661-2750
(731) 664-6817
Mailing address
180 OLD HICKORY BLVD STE L, JACKSON, TN 38305-2500
(731) 661-2750
(731) 664-6817
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21679
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
152667
UNISON
TN
01
—
27438
TLC
TN
05
—
3061622
—
TN
05
—
3061623
—
TN
01
—
4057255
BLUE CROSS BLUE SHIELD
TN
01
—
626001636
HEALTH PARTNERS
TN
01
—
JT1042
CIGNA
TN
01
—
P00034970
RAILROAD MEDICARE
TN
Enumeration date
10/31/2005
Last updated
01/19/2018
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