Provider Demographics
NPI:1780670604
Name:WHITE, AARON E (MD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:E
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:PO BOX 3528
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72913-3528
Mailing Address - Country:US
Mailing Address - Phone:479-452-2000
Mailing Address - Fax:479-274-2194
Practice Address - Street 1:20 NORTH ASTER
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:AR
Practice Address - Zip Code:72936
Practice Address - Country:US
Practice Address - Phone:479-996-4111
Practice Address - Fax:479-484-4793
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE3035207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR143716001Medicaid
OK200004980AMedicaid
P00351187OtherRR MEDICARE
ARH41930Medicare UPIN
OK200004980AMedicaid