Organization
JOHN B WHITE, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETH BLUE (BUSINESS OFFICE MANAGER)
(918) 492-7722
Entity
Organization
Contact information
Practice address
1620 E 12TH ST, TULSA, OK 74120-5407
(918) 492-7722
(918) 357-5859
Mailing address
PO BOX 140156, BROKEN ARROW, OK 74014-0002
(918) 492-7722
(918) 357-5859
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
16315
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100200630A
—
OK
Enumeration date
08/27/2007
Last updated
12/03/2007
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