Provider Demographics
NPI:1497778641
Name:WHITE, WILLIAM L (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:L
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:312 NW ROCKWOOD CT
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-2094
Mailing Address - Country:US
Mailing Address - Phone:816-525-0873
Mailing Address - Fax:
Practice Address - Street 1:1004 CARONDELET DR
Practice Address - Street 2:SUITE 405
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-4802
Practice Address - Country:US
Practice Address - Phone:816-943-1123
Practice Address - Fax:816-943-1250
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR2F23207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO20972014OtherBLUE CROSS BLUE SHIELD
KS767009OtherBLUE CROSS BLUE SHIELD
MO20972034OtherBLUE CROSS BLUE SHIELD
MO207665308Medicaid
KS100173170BMedicaid
MOE78903Medicare UPIN
MO180023142Medicare PIN
MO20972034OtherBLUE CROSS BLUE SHIELD
MO207665308Medicaid
KS100173170BMedicaid
MO20972014OtherBLUE CROSS BLUE SHIELD