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JASON T WHITE DPM

>> Podiatrist >> Podiatric Medicine & Surgery Service Providers

Registrant NPI Number: 1376640540

Individual Registrant:
 JASON T WHITE DPM
Gender: M
Sole Proprietor

Location and contact information for practice:
15 S FOREST RD  WILLIAMSVILLE, NY 14221-6425 US
Tel: 716-634-5993  Fax: 716-478-0946

Contact information for business:
15 S FOREST RD  WILLIAMSVILLE, NY 14221-6425 US
Tel: 716-634-5993  Fax: 716-478-0946

Registration Information:
NPI: 1376640540
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y213E00000XPodiatric Medicine & Surgery Service Providers
Podiatrist
NYN005864

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
02344012NY05
UNIVERA0002608000301
BLUE CROSS BLUE SHIELD WN00052692600101
BLUE CROSS BLUE SHIELD WN00052692600201




HEALTH CARE JOBS NY - Page 1



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