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DR. JERRY WADE WHITE MD NPI 1992775209


NPI Information

NPI: 1992775209
Provider Name: DR. JERRY WADE WHITE, MD
Classification: Pediatrics - 2080P0006X
Entity Type: Individual

Specialization: Developmental - Behavioral Pediatrics

Address:
650 JOEL DR
FORT CAMPBELL, KY
ZIP 42223
Phone: (270) 798-4677
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DR. Jerry Wade White, MD is a developmental - behavioral pediatrics pediatrics in Fort Campbell, KY. The provider is a developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. DR. Jerry Wade White, MD NPI is 1992775209. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

650 JOEL DR
FORT CAMPBELL, KY
ZIP 42223-318
Phone: (270) 798-4677
Fax: (270) 956-0444

The enumeration date for this NPI number is 1/26/2006 and was last updated on 7/2/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080P0006XPediatricsDevelopmental - Behavioral PediatricsC52893CALIFORNIAYes
22080P0006XPediatricsDevelopmental - Behavioral PediatricsMD.018896LOUISIANANo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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