Provider Demographics
NPI:1184767220
Name:WHITE, LORI C (MD)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:C
Last Name:WHITE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 746450
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6450
Mailing Address - Country:US
Mailing Address - Phone:866-401-3057
Mailing Address - Fax:318-868-6430
Practice Address - Street 1:575 STANTON RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36617-2344
Practice Address - Country:US
Practice Address - Phone:251-471-7207
Practice Address - Fax:251-471-7468
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL18141207Q00000X
ALMD.18141207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0403254OtherUNITED HEALTH CARE
AL051539931OtherBLUE CROSS BLUE SHIELD
AL009911824Medicaid
AL630813275OtherCOMMERICIAL GRP
AL51518354OtherBCBS
AL18141OtherLICENSE
AL630813275OtherWORKMAN COMP
AL630813275OtherCOMMERICAL PRV
ALP00426548OtherRAIL ROAD MEDICARE
AL630813275OtherCOMMERICIAL GRP
AL051558922Medicare PIN
AL51518354OtherBCBS