White, Randall G

White, Randall G is an individual health care provider with primary practice located at 745 Olive St Suite 200, Shreveport LA 71104-2246. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. White, Randall G can be contacted via phone (318) 226-0809.

Contact Information

Primary practice address
745 Olive St Suite 200 Shreveport LA 71104-2246
Phone: (318) 226-0809
Fax: (318) 226-0812
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 020186 Louisiana

Profile Details

NPI number 1801851522
LBN Legal business name White, Randall G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2006
Last updated Dec 9th, 2009 - about 15 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 1801851522 NPPES
Louisiana Other L020186 MEDICAL LICENSE
Louisiana MEDICAID 1966118 MEDICAL LICENSE

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