Provider Demographics
NPI:1053187617
Name:WHITE, JAMES MARLON III
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MARLON
Last Name:WHITE
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1732 S TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-1980
Mailing Address - Country:US
Mailing Address - Phone:216-355-8613
Mailing Address - Fax:
Practice Address - Street 1:1732 S TAYLOR RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1980
Practice Address - Country:US
Practice Address - Phone:216-355-8613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health