Individual
FREDERICK J WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2727 HEARNE AVE STE 301, SHREVEPORT, LA 71103-3918
(318) 631-6400
(318) 631-0300
Mailing address
PO BOX 37388, SHREVEPORT, LA 71133-7388
(318) 631-6400
(318) 631-0300
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
016889
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1389234
—
LA
Enumeration date
02/17/2006
Last updated
06/17/2021
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