Provider Demographics
NPI:1144261793
Name:WHITE, JOSEPH
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:WHITE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3211 SHANNON RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6322
Mailing Address - Country:US
Mailing Address - Phone:800-291-4020
Mailing Address - Fax:919-419-7247
Practice Address - Street 1:233 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:HAZLEHURST
Practice Address - State:MS
Practice Address - Zip Code:39083-2228
Practice Address - Country:US
Practice Address - Phone:800-291-4020
Practice Address - Fax:919-419-7247
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO12269207P00000X
MS12269207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine