Provider Demographics
NPI:1124017728
Name:WHITE, JAMES TERRY (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:TERRY
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3980 COLONNADE PKWY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-2382
Mailing Address - Country:US
Mailing Address - Phone:205-510-5000
Mailing Address - Fax:
Practice Address - Street 1:3980 COLONNADE PKWY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-2382
Practice Address - Country:US
Practice Address - Phone:205-510-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL24385207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALG27403Medicare UPIN
AL102I063015Medicare PIN