Individual
DR. JERRY WADE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-4677
(270) 956-0444
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-4677
(270) 956-0444
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
C52893
CA
2080P0006X
Developmental - Behavioral Pediatrics Physician
MD.018896
LA
Other
Enumeration date
01/26/2006
Last updated
01/16/2025
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