White, Jerry Wade

White, Jerry Wade is an individual health care provider with primary practice located at 650 Joel Dr , Fort Campbell KY 42223-5318. He recently has only one registered license in Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics, which is considered as his primary health care specialty. White, Jerry Wade can be contacted via phone (270) 798-4677.

Contact Information

Primary practice address
650 Joel Dr Fort Campbell KY 42223-5318
Phone: (270) 798-4677
Fax: (270) 956-0444
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics 2080P0006X C52893 California
Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics 2080P0006X MD.018896 Louisiana

Profile Details

NPI number 1992775209
LBN Legal business name White, Jerry Wade
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2006
Last updated Jul 2nd, 2019 - about 7 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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