Provider Demographics
NPI:1922026061
Name:WHITE, PATRICIA F (DO)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:F
Last Name:WHITE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 N 3RD ST
Mailing Address - Street 2:ED FRASER MEMORIAL HOSPITAL
Mailing Address - City:MACCLENNY
Mailing Address - State:FL
Mailing Address - Zip Code:32063-2103
Mailing Address - Country:US
Mailing Address - Phone:904-259-3151
Mailing Address - Fax:
Practice Address - Street 1:159 N 3RD ST
Practice Address - Street 2:ED FRASER MEMORIAL HOSPITAL
Practice Address - City:MACCLENNY
Practice Address - State:FL
Practice Address - Zip Code:32063-2103
Practice Address - Country:US
Practice Address - Phone:904-259-3151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7929207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA472178415AMedicaid
FL13656OtherBCBS
FL264215800Medicaid
GA472178415AMedicaid
FL13656OtherBCBS
FL264215800Medicaid