Provider Demographics
NPI:1952334716
Name:WHITE, JERI J (DO)
Entity Type:Individual
Prefix:
First Name:JERI
Middle Name:J
Last Name:WHITE
Suffix:
Gender:F
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:2478 PATTERSON RD
Mailing Address - Street 2:STE 27
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-3606
Mailing Address - Country:US
Mailing Address - Phone:970-242-3200
Mailing Address - Fax:970-245-0705
Practice Address - Street 1:2478 PATTERSON RD
Practice Address - Street 2:STE 27
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-3606
Practice Address - Country:US
Practice Address - Phone:970-242-3200
Practice Address - Fax:970-245-0705
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2019-08-06
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Provider Licenses
StateLicense IDTaxonomies
CO45529207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COBW5640378OtherDEA
CO82551766Medicaid
CO82551766Medicaid
COH36631Medicare UPIN