Individual
RANDALL G WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
745 OLIVE ST, SUITE 200, SHREVEPORT, LA 71104-2246
(318) 226-0809
(318) 226-0812
Mailing address
745 OLIVE ST, SUITE 200, SHREVEPORT, LA 71104-2246
(318) 226-0809
(318) 226-0812
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
020186
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1966118
—
LA
01
—
L020186
MEDICAL LICENSE
LA
Enumeration date
04/18/2006
Last updated
12/09/2009
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