White, Jewel Johnny

White, Jewel Johnny is an individual health care provider with primary practice located at 105 W Stone Dr Ste 1F, Kingsport TN 37660-3365. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. White, Jewel Johnny can be contacted via phone (423) 857-2793.

Contact Information

Primary practice address
105 W Stone Dr Ste 1F Kingsport TN 37660-3365
Phone: (423) 857-2793
Fax: (423) 578-8025
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD 16405 Tennessee

Profile Details

NPI number 1871595058
LBN Legal business name White, Jewel Johnny
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated May 20th, 2014 - about 12 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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Identifiers

StateTypeNumberIssuer
All States NPI 1871595058 NPPES
Tennessee MEDICAID 3025660
Tennessee MEDICAID 5850002

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