Provider Demographics
NPI:1598785636
Name:WHITE, PERRY MERRILL III (MD)
Entity Type:Individual
Prefix:
First Name:PERRY
Middle Name:MERRILL
Last Name:WHITE
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:P
Other - Middle Name:MERRILL
Other - Last Name:WHITE
Other - Suffix:III
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 306556
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6556
Mailing Address - Country:US
Mailing Address - Phone:865-243-8153
Mailing Address - Fax:
Practice Address - Street 1:9430 PARK WEST BLVD STE 130
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4205
Practice Address - Country:US
Practice Address - Phone:865-694-8353
Practice Address - Fax:865-693-0338
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26437207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3094154Medicaid
TN0677340002Medicare NSC
TN3094154Medicaid
E58367Medicare UPIN