Provider Demographics
NPI:1922008218
Name:WHITE, JAMES M (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:WHITE
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:455 S WASHINGTON ST
Mailing Address - Street 2:SUITE 24
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-2516
Mailing Address - Country:US
Mailing Address - Phone:717-334-9159
Mailing Address - Fax:717-334-7225
Practice Address - Street 1:455 S WASHINGTON ST
Practice Address - Street 2:SUITE 24
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2516
Practice Address - Country:US
Practice Address - Phone:717-334-9159
Practice Address - Fax:717-334-7225
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2014-01-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PA0E004950T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU25019Medicare UPIN