Individual
RICHARD A WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
515 E PROMENADE ST, MEXICO, MO 65265-2966
(573) 582-0157
(573) 581-4995
Mailing address
PO BOX 1027, JEFFERSON CITY, MO 65102-1027
(573) 681-3767
(573) 761-6947
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2005000797
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207249301
—
MO
01
—
P00239066
RR MEDICARE
MO
Enumeration date
05/18/2006
Last updated
01/07/2016
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