Provider Demographics
NPI:1821009689
Name:WHITE, PAUL DUANE (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DUANE
Last Name:WHITE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-5815
Mailing Address - Country:US
Mailing Address - Phone:828-586-2483
Mailing Address - Fax:910-454-0911
Practice Address - Street 1:1635 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-5815
Practice Address - Country:US
Practice Address - Phone:828-586-2483
Practice Address - Fax:828-586-0027
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2592111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC604081OtherACN NUMBER
NC08315OtherBCBS
NC8908315Medicaid
NC8908315Medicaid
NC2452973AMedicare ID - Type Unspecified