Provider Demographics
NPI:1679550362
Name:WHITE, JOHN J (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1305 RADFORD ST
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-2867
Mailing Address - Country:US
Mailing Address - Phone:540-381-2200
Mailing Address - Fax:540-381-8342
Practice Address - Street 1:1305 RADFORD RD
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-2867
Practice Address - Country:US
Practice Address - Phone:540-381-2200
Practice Address - Fax:540-381-8342
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-23
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101039477207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA142764OtherANTHEM
VA2140217OtherUNITED HEALTHCARE
VA7000113330OtherCIGNA
VA5997019OtherAETNA
VAP00063429OtherRR MEDICARE
VAP00063429OtherRR MEDICARE
VA2140217OtherUNITED HEALTHCARE