Individual
MR. JEFFERY WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MASTER BARBER
Contact information
Practice address
1381 PIO NONO AVE, MACON, GA 31204-4633
(478) 812-8488
Mailing address
1381 PIO NONO AVE, MACON, GA 31204-4633
(478) 812-8488
Taxonomy
Speciality
Code
Description
License number
State
156FX1900X
Orthoptist
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1111111111111111111
—
GA
Enumeration date
10/28/2020
Last updated
10/28/2020
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