White, Jewel Johnny
White, Jewel Johnny is an individual health care provider with primary practice located at 105 W Stone Dr Ste 1F, Kingsport TN 37660-3365. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. White, Jewel Johnny can be contacted via phone (423) 857-2793.Contact Information
Primary practice address
105 W Stone Dr Ste 1F
Kingsport TN 37660-3365
Phone: (423) 857-2793
Fax: (423) 578-8025
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD 16405 | Tennessee |
Profile Details
| NPI number | 1871595058 |
|---|---|
| LBN Legal business name | White, Jewel Johnny |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 1st, 2005 |
| Last updated | May 20th, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871595058 | NPPES |
| Tennessee | MEDICAID | 3025660 | |
| Tennessee | MEDICAID | 5850002 |
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