White, John M

White, John M is an individual health care provider with primary practice located at 3217 Mabel St , Shreveport LA 71103. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. White, John M can be contacted via phone (318) 631-9121.

Contact Information

Primary practice address
3217 Mabel St Shreveport LA 71103
Phone: (318) 631-9121
Fax: (318) 631-9126
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X A10390 Louisiana

Profile Details

NPI number 1558389833
LBN Legal business name White, John M
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2006
Last updated Aug 12th, 2022 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558389833 NPPES
Louisiana Other PA.A10390 STATE LICENSE
Louisiana MEDICAID 1509264 STATE LICENSE

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