Provider Demographics
NPI:1841222569
Name:WHITE, RICK (DO)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:
Last Name:WHITE
Suffix:
Gender:M
Credentials:DO
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 840862
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0862
Mailing Address - Country:US
Mailing Address - Phone:920-484-8200
Mailing Address - Fax:303-780-0787
Practice Address - Street 1:8000 E MAPLEWOOD AVE STE 200
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-4727
Practice Address - Country:US
Practice Address - Phone:303-438-3999
Practice Address - Fax:720-439-9500
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR10728207R00000X
WI3736-012111N00000X
CODR.0066676207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U83891Medicare UPIN
WI000035630Medicare ID - Type Unspecified
WI38930700Medicaid