Organization
VICTORIA Y. WARNER-WHITE M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTORIA YALONDA WARNER-WHITE M.D. (PEDIATRICIAN)
(912) 576-6464
Entity
Organization
Contact information
Practice address
2040 DAN PROCTOR DR, SUITE 230, SAINT MARYS, GA 31558-3811
(912) 576-6464
(912) 576-6460
Mailing address
2040 DAN PROCTOR DR, SUITE 230, SAINT MARYS, GA 31558-3811
(912) 576-6464
(912) 576-6460
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
039504
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00636633B
—
GA
01
—
015004
BLUE CROSS BLUE SHIELD
GA
01
—
261653847
TRICARE
GA
Enumeration date
06/13/2008
Last updated
06/13/2008
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