Provider Demographics
NPI:1164074399
Name:WHITE, STEPHEN J
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:J
Last Name:WHITE
Suffix:
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 1:5775 PEACHTREE DUNWOODY RD SUITE 600 FL. 6
Mailing Address - Street 2:UHC HEARING
Mailing Address - City:ATL.
Mailing Address - State:GA
Mailing Address - Zip Code:30342
Mailing Address - Country:US
Mailing Address - Phone:404-748-3088
Mailing Address - Fax:
Practice Address - Street 1:5775 PEACHTREE DUNWOODY RD SUITE 600 FL. 6
Practice Address - Street 2:UHC HEARING
Practice Address - City:ATL.
Practice Address - State:GA
Practice Address - Zip Code:30342
Practice Address - Country:US
Practice Address - Phone:404-748-3088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAHADS000901237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist