Provider Demographics
NPI:1659314615
Name:WHITE, TONY ARLAND (MD)
Entity Type:Individual
Prefix:DR
First Name:TONY
Middle Name:ARLAND
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:590 MEDICAL CENTER DR SW
Mailing Address - Street 2:SUITE 190
Mailing Address - City:FORT PAYNE
Mailing Address - State:AL
Mailing Address - Zip Code:35968-3418
Mailing Address - Country:US
Mailing Address - Phone:256-997-2526
Mailing Address - Fax:256-997-2553
Practice Address - Street 1:590 MEDICAL CENTER DR SW
Practice Address - Street 2:SUITE 190
Practice Address - City:FORT PAYNE
Practice Address - State:AL
Practice Address - Zip Code:35968-3418
Practice Address - Country:US
Practice Address - Phone:256-997-2526
Practice Address - Fax:256-997-2553
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00017463207P00000X
AL17463207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009933031Medicaid
F60790Medicare UPIN
AL009933031Medicaid