Provider Demographics
NPI:1730353780
Name:WHITE, WESLEY M (MD)
Entity type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:M
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1928 ALCOA HWY STE 222
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1504
Mailing Address - Country:US
Mailing Address - Phone:865-305-9254
Mailing Address - Fax:865-305-4589
Practice Address - Street 1:1928 ALCOA HWY
Practice Address - Street 2:BLDG B SUITE 222
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1502
Practice Address - Country:US
Practice Address - Phone:865-305-9254
Practice Address - Fax:865-305-9716
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-21
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0119208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty